Surgical left cardiac sympathetic denervation for long QT syndrome: effects on QT interval and heart rate

Li, Cuilan; Hu, Dayi; Shang, Lihua; Ma, Shenglin; Liu, Wen-ling; Li, Yuntian; Ma, Zhimin; Tang, Chu-Zhong; Mei, Yunqing; Wang, Lexin

doi:10.1007/s00380-005-0820-1

Cited by 25 publications

(18 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, in patients with frequent preoperative ICD discharges, a 95% decrease in ICD shocks was seen after LCSD [30]. LCSD accomplishes a decrease in cardiac adrenergic tone and a shortening of the QT interval without reducing the heart rate (as occurs with ␤ blockade) [32]; this may prove useful in patients with LQT3 who are more likely to have cardiac events with bradycardia, although little data are available to support this notion. Standard procedure The preferred procedure for LCSD involves removal of the lower half of the left stellate ganglion as well as the entire second and third thoracic ganglia [31].…”

Section: Left Cardiac Sympathetic Denervationmentioning

confidence: 99%

Congenital long QT syndrome: Diagnosis and management in pediatric patients

Bar‐Cohen

Silka²

2006

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

The long QT syndrome (LQTS) is characterized by electrocardiographic abnormalities and a high incidence of syncope and sudden cardiac death (SCD). The diagnosis is suggested when ventricular repolarization abnormalities result in prolongation of the corrected QT interval. When LQTS is suspected, genetic screening may identify a specific long QT subtype and provide guidance for appropriate therapy. Treatment depends on the relative risk of SCD, which is increased with longer QT durations, prior cardiac events, and a family history of SCD. beta Blockers are considered the initial treatment of choice, with implantable cardioverter-defibrillator (ICD) therapy warranted in high-risk patients. In patients with frequent ICD shocks or in those at high risk for SCD where ICD placement cannot be performed, cardiac pacing and/or left cardiac sympathetic denervation may be indicated.

show abstract

Section: Left Cardiac Sympathetic Denervationmentioning

confidence: 99%

Congenital long QT syndrome: Diagnosis and management in pediatric patients

Bar‐Cohen

Silka²

2006

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

show abstract

“…Short‐ and long‐term outcomes of LCSD for various cardiac arrhythmogenic diseases have been well documented . However, to the best of our knowledge, this is the first systematic and large‐scale study of LQTS patients post‐LCSD evaluating the dynamic QTc fluctuations within the 24 hour post‐surgical period using continuous QTc monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…The substrate for arrhythmogenesis involves mutations in ion channels comprising the cardiac action potential contributing to abnormal cardiac repolarization, and an increased time of ventricular repolarization . Currently, treatment options for LQTS patients involve the use of β‐blockers, placement of an implantable cardioverter‐defibrillator (ICD), and for certain patients, left cardiac sympathetic denervation (LCSD) …”

Section: Introductionmentioning

confidence: 99%

“…2,3 Currently, treatment options for LQTS patients involve the use of β-blockers, 4 placement of an implantable cardioverter-defibrillator (ICD), 5 and for certain patients, left cardiac sympathetic denervation (LCSD). [6][7][8][9] LCSD involves surgical resection of the lower half of the stellate ganglion and sympathetic chain from T1 to T4. 6,7 LCSD's anti-fibrillatory effect is thought to be due to an alteration in cardiac repolarization based on a reduction in sympathetic activation and dispersion of repolarization at the ventricular level.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects on Repolarization Using Dynamic QT Interval Monitoring in Long‐QT Patients Following Left Cardiac Sympathetic Denervation

DeSimone

Bos

et al. 2015

Cardiovasc electrophysiol

View full text Add to dashboard Cite

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 post-surgery, and at follow up ≥3 months. Results 72 patients underwent LCSD at our institution (46% male, mean age at LCSD was 14 ± 10 years). The mean baseline, pre-LCSD QTc was 505 ± 56 ms, which had decreased significantly at ≥3 months post-LCSD to 491 ± 40 ms (p = 0.001). QTc monitoring revealed that the majority of the cohort (53/72; 74%) had a transient increase >30 ms in QTc from baseline, with an average maximum increase of 72 ± 30 ms. Resolution within 10 ms of baseline or less occurred in 57% (30/53) at 24 hours post-LCSD. Conclusions Although LQTS patients may have a paradoxically increased QTc post-LCSD, the effects are transient in most patients. Importantly, no patients experienced any arrhythmias in the postoperative setting related to this transient rise in QTc.

show abstract

“…Regarding LCSD, although it seems particularly suited to patients with adrenergicmediated events (most, if not all, LQT1 and many LQT2 patients), its mechanisms of effect are not fully defined and it's effectiveness in LQT2 and LQT3 patients with rest/sleep events has not been defined. There have been a number of publications on this procedure, [33][34][35][36][37][38][39][40][41][42][43][44] but involving relatively few patients, and often the genotype was not known or not reported. Thus, the degree of genotype specificity of LCSD is unknown.…”

Section: What Is the Role Of Genotyping For Selecting Therapy For Conmentioning

confidence: 99%

Genotyping Has a Minor Role in Selecting Therapy for Congenital Long-QT Syndromes at Present

Vincent

2008

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Genotyping has led to enormous advances in understanding the phenotype and clinical course of the congenital long-QT syndromes (LQTS). In the most common LQTS forms, LQT1, LQT2, and LQT3, genotyping a clearly affected person in each family provides the ability to easily identify family members with reduced penetrance of the QTc and symptoms phenotypes, thus, providing also the opportunity to prevent sudden death and cardiac arrest by administering presymptomatic therapy. Response by Moss and Goldberg see p 233The role of genotyping in selecting the therapy for LQTS is, on the other hand, unclear. Data from the literature and from the Salt Lake City LQTS database will be presented to show that genotyping has only a minor role in selecting therapy for LQTS. The discussion will primarily address the LQT1, LQT2, and LQT3 forms (caused by mutations of the LQT1, 2, 3, 5, and 6 genes) 1 and the rare LQT4, LQT7, and LQT8 forms will be discussed briefly, and because so little is known about the new LQT9-11 forms they are not ready for a discussion of genotyping for therapy decisions. The pleural term "Long-QT syndromes" is indeed now very appropriate because of the diversity (both molecular and phenotype) of the conditions caused by the 11 accepted or proposed LQTS genes.

show abstract

Surgical left cardiac sympathetic denervation for long QT syndrome: effects on QT interval and heart rate

Cited by 25 publications

References 14 publications

Congenital long QT syndrome: Diagnosis and management in pediatric patients

Congenital long QT syndrome: Diagnosis and management in pediatric patients

Effects on Repolarization Using Dynamic QT Interval Monitoring in Long‐QT Patients Following Left Cardiac Sympathetic Denervation

Genotyping Has a Minor Role in Selecting Therapy for Congenital Long-QT Syndromes at Present

Contact Info

Product

Resources

About