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Review
. 2022 Dec;65(3):813-826.
doi: 10.1007/s10840-022-01211-2. Epub 2022 Apr 9.

Cardiac Sympathetic Denervation for the Management of Ventricular Arrhythmias

Stephanie M Kochav  1 , Hasan Garan  1 , Lyall A Gorenstein  2 , Elaine Y Wan  1 , Hirad Yarmohammadi  3   4
Affiliations
Review

Cardiac Sympathetic Denervation for the Management of Ventricular Arrhythmias

Stephanie M Kochav et al. J Interv Card Electrophysiol. 2022 Dec.

Abstract

Background: The autonomic nervous system contributes to the pathogenesis of ventricular arrhythmias (VA). Though anti-arrhythmic drug therapy and catheter ablation are the mainstay of management of VAs, success may be limited in patients with more refractory arrhythmias. Sympathetic modulation is increasingly recognized as a valuable adjunct tool for managing VAs in patients with structural heart disease and inherited arrhythmias.

Results: In this review, we explore the role of the sympathetic nervous system and rationale for cardiac sympathetic denervation (CSD) in VAs and provide a disease-focused review of the utility of CSD for patients both with and without structural heart disease.

Conclusions: We conclude that CSD is a reasonable therapeutic option for patients with VA, both with and without structural heart disease. Though not curative, many studies have demonstrated a significant reduction in the burden of VAs for the majority of patients undergoing the procedure. However, in patients with unilateral CSD and subsequent VA recurrence, complete bilateral CSD may provide long-lasting reprieve from VA.

Keywords: Cardiac sympathectomy; Incessant ventricular tachycardia; Sympathetic denervation; Ventricular arrhythmias.

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