Key result
Left cardiac sympathetic denervation was successfully performed under general anaesthesia in a 26-year-old female with refractory prolonged QT syndrome, resulting in no cardiac events at 6 months.
Why the study?
Left cardiac sympathectomy is increasingly advocated for long QT syndrome refractory to medical therapy, but patients are at risk for polymorphic ventricular tachycardia or Torsades de Pointes during anesthesia.
Case Report (n=1)
No
Careful anesthetic management using drugs with minimal QT effects allows safe left cardiac sympathetic denervation in patients with refractory long QT syndrome.
Introduction PQTS is a disorder of myocardial ion channel conduction that results in impaired ventricular repolarization. Beta blockers remain the mainstay of treatment for patients with PQTS syndrome. However, left cardiac sympathectomy is being increasingly advocated as an effective treatment for patients who are refractory to medical therapy. Patients with PQTS are at risk of developing polymorphic ventricular tachycardia or “Torsades de Pointes”. With careful preoperative preparation and by avoidance of factors that precipitate cardiac dysrhythmias during the peri operative period, patients can be safely anaesthetised for thoracic sympathectomy
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Wasala et al. (2021) conducted a case report in Prolonged QT syndrome (PQTS) (n=1). Left cardiac sympathetic denervation under general anaesthesia was evaluated on Symptom resolution and cardiac events. Left cardiac sympathetic denervation was successfully performed under general anaesthesia in a 26-year-old female with refractory prolonged QT syndrome, resulting in no cardiac events at 6 months.
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