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 John Ackerman

Research output: Contribution to journalArticle

4 Citations (Scopus)

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

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Sympathectomy
Long QT Syndrome
Cardiac Arrhythmias
Electrocardiography

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Effects on repolarization using dynamic QT interval monitoring in long-QT patients following left cardiac sympathetic denervation. / Desimone, Christopher V.; Bos, J. Martijn; Bos, Katy M.; Liang, Jackson J.; Patel, Nikhil A.; Hodge, David O.; Noheria, Amit; Asirvatham, Samuel J; Ackerman, Michael John.

In: Journal of Cardiovascular Electrophysiology, Vol. 26, No. 4, 01.04.2015, p. 434-439.

Research output: Contribution to journalArticle

Desimone, Christopher V. ; Bos, J. Martijn ; Bos, Katy M. ; Liang, Jackson J. ; Patel, Nikhil A. ; Hodge, David O. ; Noheria, Amit ; Asirvatham, Samuel J ; Ackerman, Michael John. / Effects on repolarization using dynamic QT interval monitoring in long-QT patients following left cardiac sympathetic denervation. In: Journal of Cardiovascular Electrophysiology. 2015 ; Vol. 26, No. 4. pp. 434-439.
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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.",
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N2 - 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.

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