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Video-assisted sympathectomy improved outcomes in children with refractory ventricular arrhythmias
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Video-assisted thoracoscopic left cardiac sympathetic denervation was a safe and effective procedure in children with refractory cardiac arrhythmias.
Results of a single-center experience with this technique were presented at the American Association for Thoracic Surgery Annual Meeting.
The retrospective study included 24 patients who underwent video-assisted thoracoscopic cardiac sympathetic denervation from August 2005 to December 2011. Thirteen children presented with congenital long QT syndrome, nine with catecholaminergic polymorphic ventricular tachycardia and two with idiopathic recalcitrant ventricular tachycardia. Eight children were also implanted with an ICD at the same time as denervation, according to a press release.
Long-term follow-up data were presented on 22 patients (median follow-up, 28 months).
Seventy-three percent of symptomatic children experienced a marked reduction in arrhythmia burden, and 55% became arrhythmia-free after the procedure.
Improved outcomes were observed in children who were treated after experiencing multiple symptoms despite medical therapy as well as in children unable to tolerate medical therapy, according to the release.
Researchers reported no intraoperative or perioperative complications. Median postoperative length of hospital stay was 2 days.
“This minimally invasive procedure is a promising adjunctive therapeutic option that achieves a beneficial response in the majority of symptomatic patients. These results support the inclusion of thoracoscopic cardiac sympathetic denervation amongst the treatment armamentarium in all children with ventricular arrhythmias refractive to conventional medical therapy,” Sophie C. Hofferberth, MD, from the department of cardiac surgery at Children’s Hospital Boston, and colleagues concluded in their study.
For more information:
Hofferberth S. #49: Congenital heart disease session. Presented at: the 93rd American Association for Thoracic Surgery Annual Meeting; May 4-9, 2013; Minneapolis.