Heart Rhythm. 2025 Oct 31:S1547-5271(25)03037-1. doi: 10.1016/j.hrthm.2025.10.056. Online ahead of print.
ABSTRACT
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.
PMID:41177318 | DOI:10.1016/j.hrthm.2025.10.056