title: Video-Assisted Thoracoscopic Left Cardiac Sympathetic Denervation in Patients with Hereditary Ventricular Arrhythmias.
abstract: 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. The safety and efficacy of VATS-LCSD were evaluated by periprocedural epinephrine tests and assessing the development of complications and cardiac events during follow-up.
  
  
  RESULTS
  Fourteen patients with LQTS and one patient with CPVT underwent VATS-LCSD. Six and one patients developed ventricular tachyarrhythmia during preprocedural and postprocedural epinephrine test, respectively (P = 0.063). No serious complications such as Horner syndrome, pneumothorax, or bleeding developed after LCSD. Mean hospital stay after VATS-LCSD was 3.7 ± 1.5 days. During a mean follow-up of 927 ± 350 days, one LQTS patient and one CPVT patient, neither of whom manifested tachyarrhythmia during post-LCSD epinephrine test, developed torsades de pointes and syncope, respectively. The annual event rates of six patients who were symptomatic during the period preceding LCSD decreased from 0.97 to 0.19 events/year (P = 0.045).
  
  
  CONCLUSIONS
  VATS-LCSD was a safe, and effective procedure for patients with hereditary ventricular tachycardia syndrome, with no serious adverse events and with short hospital stay.
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.|Cardiology Center, Kyungpook National University Medical Center, Daegu, Republic of Korea.
authors.forename: Se Yong
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Yongkeun
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Nam Kyun
authors.initials: NK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Chang-Yeon
authors.initials: CY
authors.lastname: Kim
authors.affiliation: Cardiology Center, Kyungpook National University Medical Center, Daegu, Republic of Korea.
authors.forename: Jihyun
authors.initials: J
authors.lastname: Sohn
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Roh
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Bae
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.|Cardiology Center, Kyungpook National University Medical Center, Daegu, Republic of Korea.
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Tak-Hyuk
authors.initials: TH
authors.lastname: Oh
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors.forename: Gun Jik
authors.initials: GJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006352:Heart Ventricles / Q000294:innervation / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008133:Long QT Syndrome / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D008297:Male; D013562:Sympathectomy / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome; D000098850:Polymorphic Catecholaminergic Ventricular Tachycardia
keywords: catecholaminergic polymorphic ventricular tachycardia; long QT syndrome; sympathectomy