Effects on repolarization using dynamic QT interval monitoring in long-QT patients following left cardiac sympathetic denervation

Christopher V. Desimone, J. Martijn Bos, Katy M. Bos, Jackson J. Liang, Nikhil A. Patel, David O. Hodge, Amit Noheria, Samuel J. Asirvatham, Michael J. Ackerman

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background Videoscopic left cardiac sympathetic denervation (LCSD) is an adjunct therapy for reduction of arrhythmia-induced events in patients with long-QT syndrome (LQTS). LCSD reduces LQTS-triggered breakthrough cardiac events. The temporal effects of QTc changes post-LCSD have not been studied. Methods We utilized continuous QTc monitoring on 72 patients with LQTS. We evaluated acute and long-term QTc changes in comparison to 12-lead ECG-derived QTc values prior to surgery, 24 hours postsurgery, and at follow up ≥3 months. Results Seventy-two patients underwent LCSD at our institution (46% male, mean age at LCSD was 14 ± 10 years). The mean baseline, pre-LCSD QTc was 505 ± 56 ms, which had decreased significantly at ≥3 months post-LCSD to 491 ± 40 ms (P = 0.001). QTc monitoring revealed that the majority of the cohort (53/72; 74%) had a transient increase >30 ms in QTc from baseline, with an average maximum increase of 72 ± 30 ms. Resolution within 10 ms of baseline or less occurred in 57% (30/53) at 24 hours post-LCSD. Conclusions Although LQTS patients may have a paradoxically increased QTc post-LCSD, the effects are transient in most patients. Importantly, no patients experienced any arrhythmias in the postoperative setting related to this transient rise in QTc.

Original languageEnglish (US)
Pages (from-to)434-439
Number of pages6
JournalJournal of cardiovascular electrophysiology
Volume26
Issue number4
DOIs
StatePublished - Apr 1 2015

Keywords

  • ICD
  • QTc
  • arrhythmia
  • left cardiac sympathetic denervation
  • long-QT syndrome
  • sudden cardiac death
  • syncope

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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