EP News—Section Editors: T. Jared Bunch, Penelope A. Boyden, N.A. Mark Estes III, Erica S. Zado| Volume 14, ISSUE 9, P1424, September 2017

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EP News: Clinical

      Vaseghi et al (Circulation 2017;135:2255, PMID 28641796) assessed the outcomes of cardiac sympathetic denervation (CSD) for refractory ventricular arrhythmias. One hundred twenty-one patients (age 55 ± 13 years; 26% women; mean ejection fraction 30% ± 13%) underwent left or bilateral CSD. One-year freedom from sustained ventricular tachycardia/implantable cardioverter-defibrillator (VT/ICD) shock and ICD shock, transplant, and death were 58% and 50%, respectively. CSD reduced the burden of ICD shocks from a mean of 18 ± 30 (median 10) in the year before study entry to 2.0 ± 4.3 (median 0) at a median follow-up of 1.1 years (P < .01). Preprocedure New York Heart Association (NYHA) functional class III and IV heart failure and longer VT cycle lengths were associated with recurrent ICD shocks. Advanced NYHA functional class, longer VT cycle lengths, and a left-sided–only procedure predicted the combined end point of sustained VT/ICD shock recurrence, death, and transplantation. Of the 120 patients taking antiarrhythmic medications before CSD, 39 (32%) no longer required them at follow-up. The authors conclude that CSD decreased sustained VT and ICD shock recurrence in patients with refractory VT.
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