Cardiac sympathectomy for refractory ventricular arrhythmias in cardiac sarcoidosis

Heart Rhythm : the Official Journal of the Heart Rhythm Society
David R OkadaHarikrishna Tandri

Abstract

Ventricular arrhythmias (VA) in cardiac sarcoidosis (CS) are frequently refractory to both antiarrhythmic drug (AAD) therapy and catheter ablation (CA). Cardiac sympathetic denervation (CSD) has been shown to reduce VA burden and implantable cardioverter-defibrillator (ICD) shocks in patients with nonischemic cardiomyopathy. We aimed to report our center's preliminary experience with CSD in patients with known or presumed CS and refractory VA. Patients with CS and refractory VA who underwent CSD at our institution were included. Patient characteristics, procedural outcomes, and number of arrhythmic events including ICD shocks pre- and post-CSD are reported. Five patients with CS (mean age 53 ± 11 years; 2 men [40%]; mean left ventricular ejection fraction 38% ± 11%) underwent CSD for VA refractory to AAD therapy and CA. Four of 5 patients underwent bilateral CSD; 1 patient underwent right-sided sympathectomy only because of poor intraoperative visualization on the left. Procedural complications included hemothorax in 1 patient and azygous vein injury in 1 patient. The median number of ICD shocks in the 6 months pre-CSD was 5. During a median follow-up of 26 months (range 5-29 months), the median number of ICD shocks post-CSD wa...Continue Reading

Citations

May 28, 2020·Pacing and Clinical Electrophysiology : PACE·Ghulam MurtazaRakesh Gopinathannair
Apr 5, 2021·JACC. Clinical Electrophysiology·Fabrizio R AssisHarikrishna Tandri
May 23, 2020·JACC. Clinical Electrophysiology·Stavros StavrakisAntonis A Armoundas
Jun 10, 2021·Methodist DeBakey Cardiovascular Journal·Ray K ChiharaMin P Kim
Aug 26, 2021·Heart Rhythm O2·Mtwesi ViweDavid H Birnie

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