Key result
Bilateral cardiac sympathetic denervation is linked to ~61% fewer ICD shocks in inherited cardiomyopathies.
Why the study?
Cardiac sympathetic denervation (CSD) is established for ischemic and non-ischemic cardiomyopathy, LQTS, and CPVT, while outcomes of CSD in patients with refractory ventricular arrhythmia and rare inherited cardiomyopathies required investigation.
Does bilateral cardiac sympathetic denervation reduce ICD shocks and improve outcomes in adult patients with refractory ventricular arrhythmias and inherited cardiomyopathies?
Observational (n=23)
Yes
Does bilateral cardiac sympathetic denervation reduce ICD shocks and improve outcomes in adult patients with refractory ventricular arrhythmias and inherited cardiomyopathies?
Bilateral cardiac sympathetic denervation significantly reduced ICD shocks by 61% and yielded a 76% 4-year transplant-free survival rate in patients with inherited cardiomyopathies and refractory ventricular arrhythmias.
May reduce ICD shocks in refractory cases; leaves open confirmation in randomized trials.
BACKGROUND Cardiac Sympathetic Denervation (CSD) is a therapeutic option in patients with recurrent or refractory ventricular arrhythmia (VA). Successful outcomes have largely been established among patients with underlying ischemic cardiomyopathy, non-ischemic cardiomyopathy, and young patients diagnosed with long-QT syndrome (LQTS) or catecholaminergic polymorphic ventricular tachycardia (CPVT). Patients with inherited cardiomyopathies have a rare prevalence and at times experience VA's and sudden cardiac death (SCD). OBJECTIVE Herein we study the outcomes of CSD on patients with refractory VA and an inherited cardiomyopathy. METHODS Data from adult patients with VA referred for CSD were reviewed from four tertiary referral centers between 2010-2023. Patients with a minimum post-op follow up time of 12 months and an inherited cardiomyopathy were included: hypertrophic cardiomyopathy (HCM), arrhythmogenic cardiomyopathy (ACM), or dilated cardiomyopathy (DCM). RESULTS 23 patients with an inherited cardiomyopathy underwent bilateral CSD: 7 HCM patients, 11 ACM patients, 5 DCM patients. The median (IQR) follow up time was 34.5 months (23.1-46.5). The overall success rate of CSD was 48%. When comparing pre- and post-CSD periods, ICD shocks decreased by 61% (p<0.01). Transplant-free survival at 4 years was 76%. The majority of expected complications resolved upon follow-up. CONCLUSION Bilateral CSD significantly reduced ICD shocks in patients with inherited cardiomyopathies, demonstrating durable arrhythmia control and favorable long-term transplant-free survival across diverse genetic subtypes.
No takes yet. Share an insight, caveat, or question.
Sarkar et al. (2025) conducted an observational in Refractory ventricular arrhythmias with inherited cardiomyopathies (n=23). Bilateral cardiac sympathetic denervation vs. Pre-CSD baseline period was evaluated on ICD shocks and overall procedural success rate (61% reduction in ICD shocks, p=<0.01). Bilateral cardiac sympathetic denervation reduced ICD shocks by 61% (p<0.01) with a 48% overall success rate and 76% 4-year transplant-free survival in inherited cardiomyopathies.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: