Limited Left Thoracoscopic Sympathectomy Effectively Silences Refractory Electrical Storm
| Autor: | Whitney Burrows, Joseph S. Friedberg, Timm Dickfeld, Eric Krause, Vincent See, Jason Appelbaum, Warren Naselsky |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty medicine.medical_treatment Catheter ablation Ventricular tachycardia Extracorporeal Membrane Oxygenation medicine Extracorporeal membrane oxygenation Humans Ganglionectomy Sympathectomy Aged Retrospective Studies business.industry Thoracic Surgery Video-Assisted Retrospective cohort study Middle Aged medicine.disease Implantable cardioverter-defibrillator Surgery Defibrillators Implantable Ventricular fibrillation Ventricular Fibrillation Tachycardia Ventricular Female Cardiology and Cardiovascular Medicine Cardioversions business |
| Zdroj: | The Annals of thoracic surgery. 113(1) |
| ISSN: | 1552-6259 |
| Popis: | Background An electrical storm (ES) is a life-threatening condition that affects up to 20% of patients with implantable cardioverter defibrillators. In this small retrospective study, we report our results with left video-assisted thoracoscopic sympathectomy/ganglionectomy (VATSG) to treat refractory ES in low–ejection fraction patients who were not candidates for catheter ablation. Methods We identified 12 patients who presented with ES and underwent a total of 14 video-assisted thoracoscopic sympathectomy/ganglionectomy, including 3 patients on venoarterial extracorporeal membrane oxygenation. We reviewed demographic data, survival to discharge, number of cardioversions (before and after VATSG), need for readmissions, and need for right-sided procedures. Results In the 30 days before a left VATSG, mean number of shocks was 22.67 for all patients. For the patients who survived to discharge, the mean was 3.55 since surgery and the median was zero shocks after a median follow-up of 358 days. Six patients did not experience further cardioversions since the last VATSG and 5 were not readmitted for ventricular tachycardia. Two patients had staged bilateral procedures owing to recurrences; of those, 1 did not require further cardioversions. Conclusions Limited left VATSG is an appropriate and effective initial treatment for ES patients who are not candidates for catheter ablation, including those on venoarterial extracorporeal membrane oxygenation for hemodynamic support. |
| Databáze: | OpenAIRE |
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