Surgical cardiac denervation therapy for treatment of congenital ion channelopathies in pediatric patients: a contemporary, single institutional experience

J P Costello, J K Wilson, C Louis, S M Peer, D Zurakowski, E P Nadler, F G Qureshi, R A Jonas, E A Greene, C I Berul, J P Moak, D S Nath

Research output: Chapter in Book/Report/Conference proceedingChapter

7 Scopus citations

Abstract

BACKGROUND: Congenital ion channel disorders, including congenital long QT syndrome (LQTS), cause significant morbidity in pediatric patients. When medication therapy does not control symptoms or arrhythmias, more invasive treatment strategies may be necessary. This study examines our institution's clinical experience with surgical cardiac denervation therapy for management of these arrhythmogenic disorders in children. METHODS: An institutional review board-approved retrospective review identified ten pediatric patients with congenital ion channelopathies who underwent surgical cardiac denervation therapy at a single institution between May 2011 and April 2014. Eight patients had a diagnosis of congenital LQTS, two patients were diagnosed with catecholaminergic polymorphic ventricular tachycardia (CPVT). All patients underwent sympathectomy and partial stellate ganglionectomy via video-assisted thoracoscopic surgery (VATS). RESULTS: Six of the ten patients had documented ventricular arrhythmias preoperatively, and 70% of the patients had preoperative syncope. The corrected QT interval decreased in 75% of patients with LQTS following sympathectomy. Postoperative arrhythmogenic symptoms were absent in 88% of congenital LQTS patients, but both patients with CPVT continued to have symptoms throughout the duration of follow-up. All patients were alive after a median follow-up period of 10 months. CONCLUSIONS: Surgical cardiac denervation therapy via VATS is a useful treatment strategy for congenital LQTS patients who fail medical management, and its potential benefit in the management of CPVT is unclear. A prospective comparison of the efficacy of surgical cardiac denervation therapy and implantable cardioverter-defibrillator use in congenital ion channelopathies is timely and crucial.
Original languageEnglish (US)
Title of host publicationWorld J Pediatr Congenit Heart Surg
Pages33-38
Number of pages6
Edition2014/12/31
DOIs
StatePublished - 2015

Publication series

NameWorld J Pediatr Congenit Heart Surg
Volume6

Keywords

  • *Sympathectomy
  • *Thoracic Surgery, Video-Assisted
  • Adolescent
  • Channelopathies/congenital/*surgery
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Long QT Syndrome/*surgery
  • Male
  • Retrospective Studies
  • Stellate Ganglion/*surgery
  • Tachycardia, Ventricular/congenital/*surgery
  • Treatment Outcome

PubMed: MeSH publication types

  • Evaluation Study
  • Journal Article

Fingerprint Dive into the research topics of 'Surgical cardiac denervation therapy for treatment of congenital ion channelopathies in pediatric patients: a contemporary, single institutional experience'. Together they form a unique fingerprint.

  • Cite this

    Costello, J. P., Wilson, J. K., Louis, C., Peer, S. M., Zurakowski, D., Nadler, E. P., Qureshi, F. G., Jonas, R. A., Greene, E. A., Berul, C. I., Moak, J. P., & Nath, D. S. (2015). Surgical cardiac denervation therapy for treatment of congenital ion channelopathies in pediatric patients: a contemporary, single institutional experience. In World J Pediatr Congenit Heart Surg (2014/12/31 ed., pp. 33-38). (World J Pediatr Congenit Heart Surg; Vol. 6). https://doi.org/10.1177/2150135114555203