Limited Left Thoracoscopic Sympathectomy Effectively Silences Refractory Electrical Storm.
Ann Thorac Surg
; 113(1): 217-223, 2022 01.
Article
en En
| MEDLINE
| ID: mdl-33545155
ABSTRACT
BACKGROUND:
An electrical storm (ES) is a life-threatening condition that affects up to 20% of patients with implantable cardioverter defibrillators. In this small retrospective study, we report our results with left video-assisted thoracoscopic sympathectomy/ganglionectomy (VATSG) to treat refractory ES in low-ejection fraction patients who were not candidates for catheter ablation.METHODS:
We identified 12 patients who presented with ES and underwent a total of 14 video-assisted thoracoscopic sympathectomy/ganglionectomy, including 3 patients on venoarterial extracorporeal membrane oxygenation. We reviewed demographic data, survival to discharge, number of cardioversions (before and after VATSG), need for readmissions, and need for right-sided procedures.RESULTS:
In the 30 days before a left VATSG, mean number of shocks was 22.67 for all patients. For the patients who survived to discharge, the mean was 3.55 since surgery and the median was zero shocks after a median follow-up of 358 days. Six patients did not experience further cardioversions since the last VATSG and 5 were not readmitted for ventricular tachycardia. Two patients had staged bilateral procedures owing to recurrences; of those, 1 did not require further cardioversions.CONCLUSIONS:
Limited left VATSG is an appropriate and effective initial treatment for ES patients who are not candidates for catheter ablation, including those on venoarterial extracorporeal membrane oxygenation for hemodynamic support.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Simpatectomía
/
Fibrilación Ventricular
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Taquicardia Ventricular
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Desfibriladores Implantables
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Cirugía Torácica Asistida por Video
Tipo de estudio:
Observational_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Thorac Surg
Año:
2022
Tipo del documento:
Article