Catheter Ablation -> Ventricular Arrhythmias -> Experimental methods D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-086 - Arrhythmia-free Survival After Sympathectomy In Ventricular Arrhythmia (ID 1357)

 L.C. Saenz Morales: Nothing relevant to disclose.


Background: The autonomic nervous system participates in the onset and maintenance of ventricular arrhythmias; sympathectomy is an alternative in the management of the arrhythmic storm (AS) possibly impacting on the survival and reduction of device therapies
Objective: The purpose of this study was to determine the recurrence of AS after bilateral sympathectomy (BS).
Methods: Kaplan-Meier survival for arrhythmia recurrence were performed using retrospective registries. Outcome was defined as the recurrence of AS diagnosed by implantable cardio-defibrillator (ICD) or another diagnostic method in patients without ICD
Results: A total of 32 patients undergoing BS were included, with a median age of 60 years (SD 13.6), 78% male with a mean LVEF of 24.9±10%. Mean cardiomyopathy etiologies were Chagasic (43.8%), Ischemic (34.4%) and idiopathic (9.4%). The 71.9% presented as AS and 56.2% requiring at least 1 previous ablation (majority endo-epicardial approach). The mean cycle length of the tachycardia was 363 msec. The most frequent indication for BS was arrhythmic recurrence (37.5%). Notably, 3 patients (9.7%) underwent cardiac transplantation (CT) and 1 was included on waiting list for CT. The most frequent complication of BS was pneumothorax (4). After BS, arrhythmic storm free survival was 78.1% with a mean follow-up of 41.6 months (95% CI: 36.8 - 49.6 months), Figure 1. The median time until the first appropriate therapy of the device was 2.2 months (IQR 0.2 to 18.1) and mortality at follow-up was 18.8%.
Conclusion: Despite a low mean LVEF and a high rate of AS as initial manifestation, arrhythmic storm-free survival after BS was close to 80% with a mean follow-up of 41 months