Why the study?
To report thoracoscopic bilateral sympathetic denervation as a potential definitive treatment option for ventricular arrhythmias refractory to medical management in a patient on ECMO.
Does thoracoscopic bilateral sympathetic denervation ameliorate refractory ventricular arrhythmias in a patient with Brugada syndrome on ECMO?
Does thoracoscopic bilateral sympathetic denervation ameliorate refractory ventricular arrhythmias in a patient with Brugada syndrome on ECMO?
Bilateral cardiac sympathetic denervation can be an effective treatment for refractory ventricular arrhythmias even in critically ill patients requiring ECMO.
May support CSD for refractory arrhythmias in Brugada syndrome; hypothesis-generating and requires prospective trials before wider use.
Genetic syndromes such as Brugada syndrome can lead to lethal ventricular arrhythmias. Cardiac Sympathetic Denervation has been shown to be effective in ameliorating refractory ventricular arrhythmias. We present a 33-year-old black female with a past medical history of Brugada syndrome with an implantable cardiac defibrillator (ICD), who presented with refractory ventricular tachycardia/atrial fibrillation leading to heart failure and cardiogenic shock, requiring Extracorporeal membrane oxygenation (ECMO). The patient subsequently underwent bilateral stellate ganglion sympathetic denervation in the setting of refractory ventricular arrhythmias. We present this case report to showcase that thoracoscopic bilateral sympathetic denervation can be an effective definitive treatment option for ventricular arrhythmias that remain refractory to medical management.
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Farran et al. (2021) studied this question.
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