Genetic syndromes such as Brugada syndrome can lead to lethal ventricular arrhythmias. Cardiac Sympathetic Denervation has been shown to be effective in ameliorating refractory ventricular arrhythmias. We present a 33-year-old black female with a past medical history of Brugada syndrome with an implantable cardiac defibrillator (ICD), who presented with refractory ventricular tachycardia/atrial fibrillation leading to cardiogenic shock, requiring Extracorporeal membrane oxygenation (ECMO). The patient subsequently underwent bilateral stellate ganglion sympathetic denervation in the setting of refractory ventricular arrhythmias. We present this case report to showcase that thoracoscopic bilateral cardiac sympathetic denervation can be an effective definitive treatment option for ventricular arrhythmias refractory to medical management.

Genetic syndrome such as Brugada syndrome can lead to lethal ventricular arrhythmias. Cardiac sympathetic denervation has been shown to be effective in ameliorating refractory ventricular arrhythmias. We present a 33‐year‐old black female with a medical history of Brugada syndrome with an implantable cardiac defibrillator who presented with refractory ventricular tachycardia leading to cardiogenic shock, requiring extracorporeal membrane oxygenation. The patient subsequently underwent bilateral stellate ganglion sympathetic denervation in the setting of refractory ventricular arrhythmias. We present this case report to showcase that thoracoscopic bilateral cardiac sympathetic denervation can be an effective treatment option for ventricular arrhythmias refractory to medical management.