Prophylactic left thoracic sympathectomy to prevent electrical storms in CPVT patients needing ICD placement

Amol Moray, Edwin P. Kirk, Peter Grant, Christoph Camphausen*

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT), a life threatening arrhythmia induced by sympathetic stimulation in susceptible individuals is often refractory to antiarrhythmic agents. First line of treatment, beta-blockers can be ineffective in up to 50% with implantable cardioverter-defibrillator (ICD) placement for refractory cases. Paradoxically ICD can be arryhthmogenic from shock-associated sympathetic stimulation, initiating more shocks and " electrical storms" This has led to the use of more effective beta blockade offered by left sympathectomy, now performed by minimally invasive video assisted thoracoscopic surgery (VATS). Sympathectomy has been traditionally performed long after ICD placement, after the patient has experienced multiple shocks, thus necessitating two procedures. We report simultaneous ICD insertion and thoracoscopic sympathectomy in a 10 year-old boy with CPVT, and suggest it as a better approach than sequential procedures. To our knowledge this is first such reported case.

Original languageEnglish
Pages (from-to)731-733
Number of pages3
JournalHeart, Lung and Circulation
Volume20
Issue number11
DOIs
Publication statusPublished - Nov 2011
Externally publishedYes

Keywords

  • Catecholaminergic polymorphic ventricular tachycardia
  • Left cervical sympathectomy
  • Video assisted thoracoscopic surgery

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