Could Denervation Reduce Recurrent Ventricular Tachyarrhythmia?

Cardiac sympathetic denervation (CSD) may help to decrease recurrent ventricular tachyarrhythmias (VT) and implantable cardioverter defibrillator (ICD) shocks in patients with structural heart disease, according to the results of a recent study.

For their study, researchers followed 121 patients with structural heart disease who underwent left of bilateral CSD for refractory VT or VT storm. Overall, 1-year freedom from sustained VT/ICD shock and ICD shock, transplant, and death were 58% and 50%, respectively.
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CSD was associated with a reduced burden of ICD shocks from a mean of 18 ± 30 in the year before study entry to 2.0 ± 4.3 at a median follow-up of 1.1 years. Of 120 patients taking antiarrhythmic medications before undergoing CSD, 39 (32%) no longer required them at follow-up.

“CSD decreased sustained VT and ICD shock recurrence in patients with refractory VT. Characteristics independently associated with recurrence and mortality were advanced heart failure, VT cycle length, and a left-sided–only procedure,” the researchers concluded.

—Michael Potts

Reference:

Vaseghi M, Barwad P, Malavassi FJ, et al. Cardiac sympathetic denervation for refractory ventricular arrhythmias. JACC. 2017;69(25). doi:10.1016/j.jacc.2017.04.035.