Left cardiac sympathetic denervation in children. A matter of facts
نویسندگان
چکیده
Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac sympathectomy (CS) is a second-line treatment for drug-refractory adrenalin-sensitive channelopathies. We present our series paediatric sympathectomies long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) as adjunctive treatment. Methods Between 2011 2021, 30 CS (28 left, 2 right) were performed by videothoracoscopy in 28 patients (21 LQTS 7 CPVT), aged 8 days to 21 years. The mean follow-up was 29 months. All treated pharmacologically before surgery, three had an implantable cardiac defibrillator (ICD). Indications with CPVT included previous arrest (3/7) sustained VT induced emotion/stress despite medication (4/7). In LQTS, indications syncope (4/21), (7/21) high risk malignant arrhythmias (10/21). Results There no intraoperative complications or deaths. Four transient palpebral ptosis mild miosis, 23/28 monitored ICD subcutaneous holter. After sympathectomy, 24/28 remain asymptomatic; experienced one received appropriate discharge. Seven (3/7 due pharmacological non-compliance) which required four improved medication. During follow-up, five high-risk ICDs primary prevention. Conclusion effective safe technique children severe CS, 85% remained asymptomatic. Medication non-compliance important cause after although occasionally required. experience, long-term remote monitoring key follow-up.
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ژورنال
عنوان ژورنال: Europace
سال: 2023
ISSN: ['1099-5129', '1532-2092']
DOI: https://doi.org/10.1093/europace/euad122.762