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Achilleas Antonopoulos, David Lawrence, Davide Patrini, Marco Scarci, Robert George, Martin Hayward, Sofoklis Mitsos, Nikolaos Panagiotopoulos
Long QT syndrome (LQTS) is an uncommon and potentially fatal cardiac channelopathy. Treatment options can be medical with β-blockers or surgical with implantable cardioverter defibrillator (ICD) implantations and left cardiac sympathetic denervation (LCSD). Purpose of this paper is through a literature review to identify the management algorithm and the role of sympathectomy in LQTS.
September 2017: Journal of Thoracic Disease
Ashley Chin, Mpiko Ntsekhe, Charle Viljoen, Johan Rossouw, Tim Pennel, Peter J Schwartz
BACKGROUND: The main causes of mortality in patients with chronic heart failure include sudden cardiac death (SCD) and progressive heart failure. Autonomic dysfunction plays a detrimental role in the progression of chronic heart failure. Left cardiac sympathetic denervation (LCSD) is an inexpensive and safe procedure which modifies autonomic innervation of the heart and is associated with a significant antifibrillatory effect. Whether LCSD reduces the risk of SCD, delays progression of heart failure and improves quality of life in patients with heart failure with reduced ejection fraction (HFrEF) is not known...
December 1, 2017: International Journal of Cardiology
Peter J Schwartz, Gaetano M De Ferrari, Luigi Pugliese
One hundred years have elapsed since Thomas Jonnesco performed the first left cardiac sympathetic denervation (LCSD) in a patient with unmanageable angina pectoris and ventricular tachyarrhythmias, and the progress in the field has surpassed imagination. Here we will review the historic basis of cardiac sympathectomy for the management of life-threatening arrhythmias and will then discuss the often forgotten critical experimental studies that provided the rationale for the amazing growth of its role in clinical management...
June 15, 2017: International Journal of Cardiology
C McNamara, P Cullen, M Rackauskas, R Kelly, K E O'Sullivan, J Galvin, D Eaton
BACKGROUND: Left cardiac sympathetic denervation (LCSD) is a surgical procedure that has been shown to have an antiarrhythmic and antifibrillatory effect. Evidence indicating its antiarrhythmic effect has been available for over 100 years. It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure. With advancements in thoracic surgery, it can be safely performed via a minimally invasive Video-Assisted Thoracoscopic Surgery (VATS) approach resulting in significantly less morbidity and a shortened inpatient stay...
August 2017: Irish Journal of Medical Science
Se Yong Jang, Yongkeun Cho, Nam Kyun Kim, Chang-Yeon Kim, Jihyun Sohn, Jae-Hyung Roh, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Shung Chull Chae, Tak-Hyuk Oh, Gun Jik Kim
BACKGROUND: Left cardiac sympathetic denervation (LCSD) has been underutilized in patients with hereditary ventricular arrhythmia syndromes such as congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). The purpose of this study was to investigate the safety and efficacy of video-assisted thoracoscopic (VATS) LCSD in such patients. METHODS: Fifteen patients (four men, 24.6 ± 10.5 years old) who underwent VATS-LCSD between November 2010 and January 2015 for hereditary ventricular arrhythmia syndromes at Kyungpook National University Hospital were enrolled in this study...
March 2017: Pacing and Clinical Electrophysiology: PACE
Yongkeun Cho
Long QT syndrome (LQTS) is a rare cardiac channelopathy associated with syncope and sudden death due to torsades de pointes and ventricular fibrillation. Syncope and sudden death are frequently associated with physical and emotional stress. Management of patients with LQTS consists of life-style modification, β-blockers, left cardiac sympathetic denervation (LCSD), and implantable cardioverter-defibrillator (ICD) implantation. Prohibition of competitive exercise and avoidance of QT-prolonging drugs are important issues in life-style modification...
November 2016: Korean Circulation Journal
Yongkeun Cho
Medications such as ß-blockers are currently the primary treatment for patients with hereditary arrhythmia syndromes such as long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT). However, these drugs are ineffective in some patients, and the other treatment option, that is implantable cardioverter defibrillator (ICD) implantation, is associated with significant complications in young and active patients. Left cardiac sympathetic denervation (LCSD) may reduce the wide gap between life-long ß-blocker medication and ICD implantation...
October 2016: Journal of Arrhythmia
Andreas Früh, Geir Siem, Henrik Holmström, Gaute Døhlen, Kristina H Haugaa
BACKGROUND: Patients with Jervell and Lange-Nielsen syndrome (JLNS) exhibit severe phenotypes that are characterized by congenital deafness, very long QT intervals, and high risk of life-threatening arrhythmias. Current treatment strategies include high doses of beta-blocker medication, left cardiac sympathetic denervation, and ICD placement, which is challenging in young children. OBJECTIVE: The purpose of this study was to evaluate the safety and effect of pacing in addition to beta-blocker treatment in children with JLNS...
November 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Andrew E Schneider, J Martijn Bos, Michael J Ackerman
BACKGROUND: Left cardiac sympathetic denervation (LCSD) exerts significant antifibrillatory effects in patients with long QT syndrome (LQTS). Recently, electromechanical window (EMW) has emerged as a novel torsadogenic marker in LQTS, superior to QT interval (QTc) in distinguishing symptomatic from asymptomatic patients. OBJECTIVE: To explore the hypothesis that LCSD improves EMW most favorably in patients with LQT1. DESIGN: From September 2006 to July 2015, 44 LQT1 and 25 LQT2 patients underwent LCSD...
September 2016: Congenital Heart Disease
Ibrahim Marai, Monther Boulos, Asaad Khoury
BACKGROUND: Left cardiac sympathetic denervation (LCSD) was reported to be effective in patients with intractable ryanodine receptor mutation-associated catecholaminergic polymorphic ventricular tachycardia (CPVT). OBJECTIVES: To report our experience with LCSD in calsequestrin (CASQ2) mutation-associated CPVT. METHODS: LCSD was performed in three patients with CASQ2 mutation-associated CPVT with symptoms and exercise-induced ventricular arrhythmia despite high dose beta-blocker RESULTS: None of them experienced symptoms or exercise-induced ventricular arrhythmia after LCSD...
September 2015: Israel Medical Association Journal: IMAJ
Ryan M Antiel, J Martijn Bos, Daniel D Joyce, Heidi J Owen, Penny L Roskos, Christopher Moir, Michael J Ackerman
BACKGROUND: Left cardiac sympathetic denervation (LCSD) provides an additive or potentially alternative treatment option for patients with life-threatening cardiac channelopathies/cardiomyopathies. OBJECTIVE: We sought to examine the effects of LCSD on quality of life (QOL). METHODS: From November 2005 to May 2013, 109 patients who underwent LCSD were subsequently sent postoperative QOL surveys. RESULTS: Of 109 patients, 8 (7%) could not be contacted...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Troy Rhodes, Raul Weiss
Congenital long QT syndrome (LQTS) is an inherited disorder of myocardial repolarization characterized by prolongation of the QT interval associated with life-threatening polymorphic ventricular tachycardia. The treatment of congenital LQTS involves antiadrenergic therapies: β-blockers and surgical left cardiac sympathetic denervation (LCSD) to decrease sympathetic input to the heart, cardiac pacing, and implantable cardioverter-defibrillator (ICDs). Although this article focuses on the role of device therapy for the treatment of LQTS, it also discusses the role of β-blockers and LCSD because they are concomitant with device therapy...
September 2015: Cardiac Electrophysiology Clinics
Woo-Sik Yu, Tae-Hoon Kim, Jee Won Suh, Seunghwan Song, Chang Young Lee, Boyoung Joung
A patient presented with loss of consciousness and conversion. During an exercise test, catecholaminergic polymorphic ventricular tachycardia (CPVT) resulted in cardiac arrest. He started taking medication (a beta-blocker and flecainide) and an implantable cardioverter defibrillator (ICD) was inserted, but the ventricular tachycardia did not resolve. Left cardiac sympathetic denervation (LCSD) was then performed under general anesthesia, and the patient was discharged on the second postoperative day without complications...
June 2015: Korean Journal of Thoracic and Cardiovascular Surgery
Gaetano M De Ferrari, Veronica Dusi, Carla Spazzolini, J Martijn Bos, Dominic J Abrams, Charles I Berul, Lia Crotti, Andrew M Davis, Michael Eldar, Maria Kharlap, Asaad Khoury, Andrew D Krahn, Antoine Leenhardt, Christopher R Moir, Attilio Odero, Louise Olde Nordkamp, Thomas Paul, Ferran Rosés I Noguer, Maria Shkolnikova, Jan Till, Arthur A M Wilde, Michael J Ackerman, Peter J Schwartz
BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic disorder causing life-threatening arrhythmias whenever sympathetic activity increases. β-Βlockers are the mainstay of therapy; when they fail, implantable cardioverter-defibrillators (ICDs) are used but often cause multiple shocks. Preliminary results with flecainide appear encouraging. We proposed left cardiac sympathetic denervation (LCSD) as useful additional therapy, but evidence remains anecdotal...
June 23, 2015: Circulation
Kavitha N Pundi, J Martijn Bos, Bryan C Cannon, Michael J Ackerman
BACKGROUND: Long QT syndrome (LQTS) is a potentially lethal yet highly treatable cardiac channelopathy. A comprehensive LQTS-directed treatment program often includes an automated external defibrillator (AED). OBJECTIVE: The purpose of this study was to determine the incidence of AED rescues among children evaluated, risk-stratified, and treated in an LQTS specialty center. METHODS: We performed a retrospective review of the electronic medical records to identify 1665 patients evaluated in our Genetic Heart Rhythm Clinic (1999-2013)...
April 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Christopher V Desimone, J Martijn Bos, Katy M Bos, Jackson J Liang, Nikhil A Patel, David O Hodge, Amit Noheria, Samuel J Asirvatham, Michael J Ackerman
BACKGROUND: Videoscopic left cardiac sympathetic denervation (LCSD) is an adjunct therapy for reduction of arrhythmia-induced events in patients with long-QT syndrome (LQTS). LCSD reduces LQTS-triggered breakthrough cardiac events. The temporal effects of QTc changes post-LCSD have not been studied. METHODS: We utilized continuous QTc monitoring on 72 patients with LQTS. We evaluated acute and long-term QTc changes in comparison to 12-lead ECG-derived QTc values prior to surgery, 24 hours postsurgery, and at follow up ≥3 months...
April 2015: Journal of Cardiovascular Electrophysiology
Peter J Schwartz
Experimental and clinical evidence indicating an antiarrhythmic effect of cardiac sympathetic denervation has been available for 100 years. Experimental data show that left cardiac sympathetic denervation (LCSD), in particular, is not only antiarrhythmic, but also antifibrillatory-an effect exquisitely important for any clinical condition associated with a high risk of ventricular fibrillation and sudden cardiac death. LCSD has additional effects on both the coronary circulation and the mechanical performance of the left ventricle, with important implications for patients with ischaemic cardiomyopathy...
June 2014: Nature Reviews. Cardiology
L R A Olde Nordkamp, A H G Driessen, A Odero, N A Blom, D R Koolbergen, P J Schwartz, A A M Wilde
INTRODUCTION: Treating therapy-resistant patients with inherited arrhythmia syndromes can be difficult and left cardiac sympathetic denervation (LCSD) might be a viable alternative treatment option. We provide an overview of the indications and outcomes of LCSD in patients with inherited arrhythmia syndromes in the only tertiary referral centre in the Netherlands where LCSD is conducted in these patients. METHODS: This was a retrospective study, including all patients with inherited arrhythmia syndromes who underwent LCSD in our institution between 2005 and 2013...
April 2014: Netherlands Heart Journal
Gaetano M De Ferrari, Peter J Schwartz
Heart failure (HF) is characterized by an autonomic imbalance with withdrawal of vagal activity and increased sympathetic activity. Novel non-pharmacological approaches to HF aimed at increasing vagal activity are being proposed. Left cardiac sympathetic denervation (LCSD) has been shown to modify favorably the outcome of several disorders characterized by life-threatening arrhythmias triggered by increased sympathetic activity. The present manuscript discusses the rationale and the limited experimental and clinical experience suggesting a potential role for LCSD in the treatment of patients with advanced heart failure...
April 2014: Journal of Cardiovascular Translational Research
Xiang Qian Lao, Ignatius Tak Sun Yu, Dennis Kin Kwok Au, Yuk Lan Chiu, Claudie Chiu Yi Wong, Tze Wai Wong
BACKGROUND: Noise-induced hearing loss (NIHL) is a major concern in the non-manufacturing industries. This study aimed to investigate the occupational noise exposure and the NIHL among Chinese restaurant workers and entertainment employees working in the service industry in Hong Kong. METHODS: This cross-sectional survey involved a total of 1,670 participants. Among them, 937 were randomly selected from the workers of Chinese restaurants and 733 were selected from workers in three entertainment sectors: radio and television stations; cultural performance halls or auditoria of the Leisure and Cultural Services Department (LCSD); and karaoke bars...
2013: PloS One
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