INTRODUCTION: Cardiac sympathetic denervation (CSD) is utilized for the management of ventricular tachycardia (VT) in structural heart disease when refractory to radiofrequency ablation (RFA) or when patient/VT characteristics are not conducive to RFA. METHODS: We studied consecutive patients who underwent CSD at our institution from 2009 to 2018 with VT requiring repeat RFA post-CSD. Patient demographics, VT/procedural characteristics, and outcomes were assessed. RESULTS: Ninety-six patients had CSD, 16 patients underwent RFA for VT post-CSD. There were 15 male and 1 female patients with mean age of 54.2 ± 13.2 years. Fourteen patients had nonischemic cardiomyopathy. A mean of 2.0 ± 0.8 RFAs for VT was unsuccessful before the patient undergoing CSD. The median time between CSD and RFA was 104 days (interquartile range [IQR] = 15-241). The clinical VT cycle length was significantly increased after CSD both spontaneously on ECG and/or ICD interrogation (355 ± 73 ms pre-CSD vs. 422 ± 94 ms post-CSD, p = .001) and intraprocedurally (406 ± 86 ms pre-CSD vs. 457 ± 88 ms post-CSD, p = .03). Two patients had polymorphic and 14 had monomorphic VT (MMVT) pre-CSD, and all patients had MMVT post-CSD. The proportion of mappable, hemodynamically stable VTs increased from 35% during pre-CSD RFA to 58% during post-CSD RFA (p = .038). At median follow-up of 413 days (IQR = 43-1840) after RFA, eight patients had no further VT. CONCLUSION: RFA for recurrent MMVT post-CSD is a reasonable treatment option with intermediate-term clinical success in 50% of patients. Clinical VT cycle length was significantly increased after CSD with associated improvement in mappable, hemodynamically tolerated VT during RFA.
INTRODUCTION: Cardiac sympathetic denervation (CSD) is utilized for the management of ventricular tachycardia (VT) in structural heart disease when refractory to radiofrequency ablation (RFA) or when patient/VT characteristics are not conducive to RFA. METHODS: We studied consecutive patients who underwent CSD at our institution from 2009 to 2018 with VT requiring repeat RFA post-CSD. Patient demographics, VT/procedural characteristics, and outcomes were assessed. RESULTS: Ninety-six patients had CSD, 16 patients underwent RFA for VTpost-CSD. There were 15 male and 1 female patients with mean age of 54.2 ± 13.2 years. Fourteen patients had nonischemic cardiomyopathy. A mean of 2.0 ± 0.8 RFAs for VT was unsuccessful before the patient undergoing CSD. The median time between CSD and RFA was 104 days (interquartile range [IQR] = 15-241). The clinical VT cycle length was significantly increased after CSD both spontaneously on ECG and/or ICD interrogation (355 ± 73 ms pre-CSD vs. 422 ± 94 ms post-CSD, p = .001) and intraprocedurally (406 ± 86 ms pre-CSD vs. 457 ± 88 ms post-CSD, p = .03). Two patients had polymorphic and 14 had monomorphic VT (MMVT) pre-CSD, and all patients had MMVT post-CSD. The proportion of mappable, hemodynamically stable VTs increased from 35% during pre-CSD RFA to 58% during post-CSD RFA (p = .038). At median follow-up of 413 days (IQR = 43-1840) after RFA, eight patients had no further VT. CONCLUSION: RFA for recurrent MMVT post-CSD is a reasonable treatment option with intermediate-term clinical success in 50% of patients. Clinical VT cycle length was significantly increased after CSD with associated improvement in mappable, hemodynamically tolerated VT during RFA.
Authors: Ioan Liuba; David S Frankel; Michael P Riley; Mathew D Hutchinson; David Lin; Fermin C Garcia; David J Callans; Gregory E Supple; Sanjay Dixit; Rupa Bala; Fabien Squara; Erica S Zado; Francis E Marchlinski Journal: Heart Rhythm Date: 2014-02-19 Impact factor: 6.343
Authors: Roderick Tung; Marmar Vaseghi; David S Frankel; Pasquale Vergara; Luigi Di Biase; Koichi Nagashima; Ricky Yu; Sitaram Vangala; Chi-Hong Tseng; Eue-Keun Choi; Shaan Khurshid; Mehul Patel; Nilesh Mathuria; Shiro Nakahara; Wendy S Tzou; William H Sauer; Kairav Vakil; Usha Tedrow; J David Burkhardt; Venkatakrishna N Tholakanahalli; Anastasios Saliaris; Timm Dickfeld; J Peter Weiss; T Jared Bunch; Madhu Reddy; Arun Kanmanthareddy; David J Callans; Dhanunjaya Lakkireddy; Andrea Natale; Francis Marchlinski; William G Stevenson; Paolo Della Bella; Kalyanam Shivkumar Journal: Heart Rhythm Date: 2015-05-30 Impact factor: 6.343
Authors: B Berte; F Sacher; J Venlet; D Andreu; S Mahida; B Aldhoon; T DE Potter; A Sarkozy; R Tavernier; M Andronache; T Deneke; J Kautzner; A Berruezo; H Cochet; K Zeppenfeld; Pierre Jaïs Journal: J Cardiovasc Electrophysiol Date: 2015-11-25
Authors: Jason S Bradfield; Justin Hayase; Kevin Liu; John Moriarty; Stephen T Kee; Duc Do; Olujimi A Ajijola; Marmar Vaseghi; Jean Gima; Julie Sorg; Shelly Cote; Geraldine Pavez; Eric Buch; Houman Khakpour; Yuliya Krokhaleva; Carlos Macias; Osamu Fujimura; Noel G Boyle; Kalyanam Shivkumar Journal: Heart Rhythm Date: 2019-09-17 Impact factor: 6.343
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Saenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: Heart Rhythm Date: 2019-05-10 Impact factor: 6.343