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

Katsunori Okajima1, Kunihiko Kiuchi1, Kiminobu Yokoi1

  • 1Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan.

Journal of Arrhythmia
|March 8, 2016
PubMed

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.

Keywords:
Catecholaminergic polymorphic ventricular tachycardiaImplantable cardioverter defibrillatorThoracoscopic bilateral sympathectomy

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