Efficacy of bilateral thoracoscopic sympathectomy in a patient with catecholaminergic polymorphic ventricular tachycardia

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• 作者：Katsunori Okajima ; MD^a ; ^{kokajima@hbhc.jp" class="auth_mail" title="E-mail the corresponding author} ; Kunihiko Kiuchi ; MD ; FHRS^a ; Kiminobu Yokoi ; MD^a ; Jin Teranishi ; MD^a ; Kosuke Aoki ; MD^a ; Akira Shimane ; MD^a ; Yoshihide Nakamura ; MD^b ; Motoko Kimura ; MD^c ; Yoshio Horikawa ; MD^c ; Masato Yoshida ; MD^d ; Yoshimasa Maniwa ; MD^e
• 关键词：Catecholaminergic polymorphic ventricular tachycardia ; Thoracoscopic bilateral sympathectomy ; Implantable cardioverter defibrillator
• 刊名：Journal of Arrhythmia
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：32
• 期：1
• 页码：62-66
• 全文大小：1226 K

文摘

A 27-year-old woman with frequent implantable cardioverter defibrillator (ICD) shocks related to catecholaminergic polymorphic ventricular tachycardia (VT) experienced aborted sudden death due to incessant polymorphic VT despite the administration of beta-blockers, verapamil, and flecainide. Catheter ablation failed to suppress the polymorphic VT. Based on the temporary efficacy of the local anesthetic administered at the left and right cervical sympathetic nerves to suppress VT under an isoproterenol infusion, stepwise, bilateral thoracoscopic sympathectomy was performed. Postoperatively, no further VT or syncopal episodes were documented under ICD telemetry. Bilateral thoracoscopic sympathectomy may be an alternative for patients with drug-refractory catecholaminergic polymorphic VT.