Key result
VATS-LCSD in patients with Long QT syndrome significantly reduced the annual event rate from 4 to 0.63 events/year (P=0.034) and shortened average QTc from 534 ms to 503 ms at 24 hours (P=0.030).
Why the study?
Does video-assisted thoracoscopic left cardiac sympathetic denervation improve QTc intervals and reduce cardiac events in Chinese patients with Long QT syndrome?
Observational (n=8)
Does video-assisted thoracoscopic left cardiac sympathetic denervation improve QTc intervals and reduce cardiac events in Chinese patients with Long QT syndrome?
Absolute Event Rate: 0.63% vs 4%
p-value: p=0.034
VATS-LCSD significantly shortens QTc and reduces the annual cardiac event rate in Chinese patients with Long QT syndrome, offering a safe and effective adjunctive therapy.
VATS-LCSD was associated with fewer events and QTc shortening in LQTS; extends observational data to Chinese patients but leaves open need for RCTs.
Long QT syndrome is a rare but potentially lethal cardiac channelopathy. The primary aim of the study was to investigate the long-term effects of video-assisted thoracoscopic (VATS) left cardiac sympathetic denervation (LCSD) in Chinese patients with long QT syndrome.VATS-LCSD was performed in eight Chinese patients with LQTS. Twelve-lead ECGs and 24-hour Holter monitoring ECGs were recorded before and after surgery. The medical charts were reviewed to obtain patient data, and the patients who had been lost to follow-up were contacted through telephone.The average QTc was shortened from 534 ± 52.7 to 503 ± 43.7 ms (P = 0.030) 24 hours post-surgery and down to 486 ± 34.8 ms (P = 0.021) 1 week post-surgery, with the heart rate unchanged. The average QT dispersion was reduced from 67 ± 17.5 to 21 ± 3.9 ms (P < 0.001) 24 hours post-surgery and remained shortened 1 week later (30 ± 8.1 ms, P < 0.001). Moreover, the 24-hour ECG showed that the QTc was shortened from 552 ± 95.9 to 497 ± 19.7 ms at the minimum heart rate (P = 0.008), and was decreased from 594 ± 144 to 495 ± 74.1 ms at the maximum heart rate (P= 0.04), while the minimum and maximum heart rates were comparable before and after surgery. No death was observed during the follow-up period and the clinical symptoms improved in all patients. The annual event rate decreased from 4 ± 3.50 to 0.63 ± 1.37 events/year (P = 0.034) after surgery.These findings indicate that LCSD shortens the QTc, with the heart rate remaining unchanged. QTd might be a useful parameter for evaluating the efficacy of VATS-LCSD. LCSD could improve patients' life quality by reducing cardiac events.
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Li et al. (2018) conducted an observational in Long QT syndrome (n=8). Video-assisted thoracoscopic left cardiac sympathetic denervation (VATS-LCSD) vs. Baseline (before surgery) was evaluated on Annual event rate (p=0.034). VATS-LCSD in patients with Long QT syndrome significantly reduced the annual event rate from 4 to 0.63 events/year (P=0.034) and shortened average QTc from 534 ms to 503 ms at 24 hours (P=0.030).
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