Outcome of Patients With Systolic Heart Failure Who Underwent Sympathectomy for Ventricular Arrhythmia

Am J Cardiol. 2024 Aug 15:225:37-40. doi: 10.1016/j.amjcard.2024.05.035. Epub 2024 Jun 11.

Abstract

Cardiac sympathetic denervation (CSD) is a surgical procedure increasingly used for managing ventricular arrhythmia refractory to conventional medical therapy. Long-term outcomes of CSD in patients with systolic heart failure has not been well studied. This observational study aimed to evaluate the medical co-morbidities and outcomes of patients with systolic heart failure who underwent CSD performed as treatment for ventricular arrhythmia refractory to conventional therapy. A retrospective analysis in adult patients with ventricular arrhythmia and systolic heart failure who underwent unilateral or bilateral CSD at a single center was performed. Unadjusted Kaplan-Meier survival curves were constructed to evaluate survival after CSD. Between June 1, 2011 and March 31, 2021, 32 adult patients (age 62 ± 11.6 years, 88% male, left ventricular ejection fraction 22% ± 8.2%) with systolic heart failure underwent unilateral left (n = 4), unilateral right (n = 1), or bilateral CSD (n = 27). Mean survival after CSD was 613 ± 745 days, and the mean time from CSD to death was 291 ± 447 days. The cumulative probability of survival 1 year after CSD was 61.4%. In this single-center observational study, CSD performed for refractory ventricular arrhythmia showed favorable survival in patients with systolic heart failure. In conclusion, this study lays the groundwork for a more in-depth analysis of the potential survival benefits of CSD in this patient group.

Keywords: Cardiac sympathetic denervation (CSD); sympathectomy; systolic heart failure; ventricular arrhythmia.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Heart Failure, Systolic* / physiopathology
  • Heart Failure, Systolic* / surgery
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stroke Volume / physiology
  • Survival Rate / trends
  • Sympathectomy* / methods
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / surgery
  • Treatment Outcome