ArticleHeart rhythm O22025
Simplified left cardiac sympathetic denervation as an acute strategy for recurrent ventricular tachycardia in multimorbid patients with structural heart disease: A case series.
Article in Heart rhythm O2, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Cardiac Sympathetic Neuromodulation in the Management of Refractory Electrical Storm: A Narrative Review.Journal of clinical medicine · 2026Review
- Visualization of the thoracic sympathetic chain in MLS embalmed body donors: a feasibility study and surgical perspective.Journal of thoracic disease · 2026Article
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Authors and funding
10 authors.
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Abstract
Background: Cardiac sympathetic denervation as a treatment for drug-refractory ventricular arrhythmias (VAs) involves video-assisted thoracoscopic removal of the stellate ganglion (SG) and thoracic ganglia. A simplified approach sparing the SG and targeting left T2-T4 ganglia (left cardiac sympathetic denervation [LCSD]) may offer a less invasive alternative. Objective: This study aimed to evaluate the efficacy and safety of simplified SG-sparing LCSD as a bailout procedure for multimorbid patients with structural heart disease and recurrent VAs refractory to antiarrhythmic drugs and/or catheter ablation. Methods: All patients undergoing SG-sparing LCSD at our institution between June 2023 and June 2024 were included in this single-center retrospective study. Baseline demographics, procedural complications, and arrhythmia outcomes were analyzed. Results: LCSD was performed in 7 patients (mean age 75.9 ± 6.7 years, mean LVEF 30.7 ± 10.9%) with structural heart disease (nonischemic cardiomyopathy, n = 3; ischemic cardiomyopathy, n = 4) mostly 1 day (interquartile range 1-21) after admission with a procedure duration of 20.7 ± 5.3 minutes. Initially, 4 patients (57.1%) had electrical storm. Apart from 1 pleural effusion requiring drainage, no major complications or Horner's syndrome occurred. During a follow-up of 7 ± 2.6 months, median VA episodes requiring implantable cardioverter-defibrillator therapy decreased from 14 to 2 ( Conclusion: In this case series of 7 patients, SG-sparing LCSD demonstrated promising results in terms of safety and efficacy for reducing VAs. Further studies are warranted to confirm long-term outcomes with this approach.
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