Efficacy of bilateral thoracoscopic sympathectomy in a patient with catecholaminergic polymorphic ventricular tachycardia

Katsunori Okajima, MD; Kunihiko Kiuchi, MD, FHRS; Kiminobu Yokoi, MD; Jin Teranishi, MD; Kosuke Aoki, MD; Akira Shimane, MD; Yoshihide Nakamura, MD; Motoko Kimura, MD; Yoshio Horikawa, MD; Masato Yoshida, MD; Yoshimasa Maniwa, MD

doi:10.1016/j.joa.2015.07.002

Journal of Arrhythmia (Feb 2016)

Efficacy of bilateral thoracoscopic sympathectomy in a patient with catecholaminergic polymorphic ventricular tachycardia

Katsunori Okajima, MD,
Kunihiko Kiuchi, MD, FHRS,
Kiminobu Yokoi, MD,
Jin Teranishi, MD,
Kosuke Aoki, MD,
Akira Shimane, MD,
Yoshihide Nakamura, MD,
Motoko Kimura, MD,
Yoshio Horikawa, MD,
Masato Yoshida, MD,
Yoshimasa Maniwa, MD

Affiliations

Katsunori Okajima, MD: Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan
Kunihiko Kiuchi, MD, FHRS: Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan
Kiminobu Yokoi, MD: Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan
Jin Teranishi, MD: Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan
Kosuke Aoki, MD: Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan
Akira Shimane, MD: Department of Cardiology, Himeji Cardiovascular Center, 520 Saisho-ko, Himeji, Hyogo Prefecture, Japan
Yoshihide Nakamura, MD: Department of Pediatrics, Kinki University Graduate School of Medicine, Japan
Motoko Kimura, MD: Department of Anesthesia, Himeji Cardiovascular Center, Japan
Yoshio Horikawa, MD: Department of Anesthesia, Himeji Cardiovascular Center, Japan
Masato Yoshida, MD: Department of Cardiovascular Surgery, Himeji Cardiovascular Center, Japan
Yoshimasa Maniwa, MD: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Japan

DOI: https://doi.org/10.1016/j.joa.2015.07.002
Journal volume & issue: Vol. 32, no. 1
pp. 62 – 66

Abstract

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A 27-year-old woman with frequent implantable cardioverter defibrillator (ICD) shocks related to catecholaminergic polymorphic ventricular tachycardia (VT) experienced aborted sudden death due to incessant polymorphic VT despite the administration of beta-blockers, verapamil, and flecainide. Catheter ablation failed to suppress the polymorphic VT. Based on the temporary efficacy of the local anesthetic administered at the left and right cervical sympathetic nerves to suppress VT under an isoproterenol infusion, stepwise, bilateral thoracoscopic sympathectomy was performed. Postoperatively, no further VT or syncopal episodes were documented under ICD telemetry. Bilateral thoracoscopic sympathectomy may be an alternative for patients with drug-refractory catecholaminergic polymorphic VT.

Published in Journal of Arrhythmia

ISSN: 1880-4276 (Print); 1883-2148 (Online)
Publisher: Wiley
Country of publisher: Australia
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://onlinelibrary.wiley.com/journal/18832148

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