Cardiac sympathetic denervation for refractory ventricular arrhythmias in patients with structural heart disease: A systematic review.

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Citation: Heart Rhythm. 16(10):1499-1505, 2019 10.PMID: 31252084Institution: Medstar Union Memorial HospitalDepartment: Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Heart Diseases/ep [Epidemiology] | *Sympathectomy/mt [Methods] | *Tachycardia, Ventricular/ep [Epidemiology] | *Tachycardia, Ventricular/su [Surgery] | Aged | Comorbidity | Female | Heart Diseases/dg [Diagnostic Imaging] | Heart Diseases/pp [Physiopathology] | Humans | Male | Middle Aged | Postoperative Complications/ep [Epidemiology] | Postoperative Complications/pp [Physiopathology] | Prognosis | Recurrence | Risk Assessment | Survival Rate | Sympathectomy/ae [Adverse Effects] | Tachycardia, Ventricular/dg [Diagnostic Imaging] | Treatment OutcomeYear: 2019Local holdings: Available online through MWHC library: 2004 - presentISSN:
  • 1547-5271
Name of journal: Heart rhythmAbstract: BACKGROUND: Cardiac sympathetic denervation (CSD) is an important adjunctive option for patients with refractory ventricular arrhythmias (VAs). Reports of efficacy of CSD in patients with structural heart disease (SHD) and refractory VA vary widely in literature.CONCLUSION: CSD reduced the number of VA events in patients with SHD, and the benefit from the intervention seemed to be independent of the underlying SHD. Although overall rate of postprocedural complications was high, most of the complications were temporary. Major postprocedural complications after CSD were infrequent.Copyright (c) 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.METHODS: Electronic databases (Google Scholar and PubMed) were searched to identify reports on CSD in SHD using appropriate medical subject terms. No sample size restriction was applied. All patients with known channelopathies were excluded. Baseline demographic and surgical data, arrhythmic outcomes, and procedural complications were evaluated.OBJECTIVE: The purpose of this study was to conduct a systematic review of arrhythmic outcomes and complications in patients with SHD who underwent CSD due to recurrent VAs.RESULTS: A total of 13 studies and 173 patients were included. Of the 173 patients (121 [70%] male); pooled mean age 54.6 [95% confidence interval 52.6-56.7] years), 48 (28%) had ischemic cardiomyopathy, and 141 (82%) underwent bilateral CSD. Overall freedom from events ranged from 58% to 100%. Complications were reported in 49 patients(28%). Transient hypotension (9%), pneumothorax (5%), neuropathic pain (skin sensitivity) (4%), Horner syndrome (3%), sweating pattern changes (3%), and hemothorax (2%) were the most common complications. No procedure-related deaths were reported.All authors: Alugubelli N, Assis F, Cardoso R, Okada DR, Shah R, Shivkumar K, Tandri HOriginally published: Heart Rhythm. 2019 Jun 25Fiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-07-24
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 31252084 Available 31252084

Available online through MWHC library: 2004 - present

BACKGROUND: Cardiac sympathetic denervation (CSD) is an important adjunctive option for patients with refractory ventricular arrhythmias (VAs). Reports of efficacy of CSD in patients with structural heart disease (SHD) and refractory VA vary widely in literature.

CONCLUSION: CSD reduced the number of VA events in patients with SHD, and the benefit from the intervention seemed to be independent of the underlying SHD. Although overall rate of postprocedural complications was high, most of the complications were temporary. Major postprocedural complications after CSD were infrequent.

Copyright (c) 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

METHODS: Electronic databases (Google Scholar and PubMed) were searched to identify reports on CSD in SHD using appropriate medical subject terms. No sample size restriction was applied. All patients with known channelopathies were excluded. Baseline demographic and surgical data, arrhythmic outcomes, and procedural complications were evaluated.

OBJECTIVE: The purpose of this study was to conduct a systematic review of arrhythmic outcomes and complications in patients with SHD who underwent CSD due to recurrent VAs.

RESULTS: A total of 13 studies and 173 patients were included. Of the 173 patients (121 [70%] male); pooled mean age 54.6 [95% confidence interval 52.6-56.7] years), 48 (28%) had ischemic cardiomyopathy, and 141 (82%) underwent bilateral CSD. Overall freedom from events ranged from 58% to 100%. Complications were reported in 49 patients(28%). Transient hypotension (9%), pneumothorax (5%), neuropathic pain (skin sensitivity) (4%), Horner syndrome (3%), sweating pattern changes (3%), and hemothorax (2%) were the most common complications. No procedure-related deaths were reported.

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