Cauti, F. M., Rossi, P., Bianchi, S., Magnocavallo, M., Capone, S., Rocca, D. G. D., Polselli, M., Bruno, K., Tozzi, P., Rossi, C., Vannucci, J., Pugliese, F., Quaglione, R., Venuta, F., & Anile, M. (2025). Modified sympathicotomy in patients with refractory ventricular tachycardia and structural heart disease: a single-center experience. Journal of Interventional Cardiac Electrophysiology, 68(2), 391-399. https://doi.org/10.1007/s10840-023-01706-6

@article{db46e0f94f2a42c5a0ad48d71b393a7d,
title = "Modified sympathicotomy in patients with refractory ventricular tachycardia and structural heart disease: a single-center experience",
abstract = "Background Modified cardiac sympathetic denervation (CSD) with stellate ganglion (SG) sparing is a novel technique for cardiac neuromodulation in patients with refractory ventricular tachycardia (VT). Objectives Our aim is to describe the mid- to long-term clinical outcome of the modified CSD with SG sparing in a series of patients with structural heart disease (SHD) and refractory VT. Methods All consecutive patients with SHD and refractory VT undergoing modified CSD were enrolled. Baseline clinical characteristics and periprocedural data were collected for all patients. The primary outcome was any recurrence of sustained VT. Results We enrolled 15 patients (age: 69.2 ± 7.9 years; male 100\%) undergoing modified CSD. Left ventricular ejection fraction was 37 ± 11\% and all patients had an implantable cardiac defibrillator (ICD); the underlying cardiomyopathy was non-ischemic in 73.3\% of them. At least one previous ablation had been attempted in 66.6\% of cases. The 73.3\% of patients underwent bilateral CSD and the mean effective surgical time was 10.8 ± 2.4 min per side; no major periprocedural complication occurred. After a median follow-up time of 15 months (IQR: 8.5–24.5 months), the primary outcome occurred in 47.6\% of cases. All patients experienced a reduction of ICD shocks after CSD (3.1 ICD shocks/patient before vs. 0.3 ICD shocks/patient after CSD; p-value: 0.001). Bilateral CSD and a VT cycle length < 340 ms were associated with better outcomes. Conclusions A modified CSD approach with stellate ganglion sparing appears to be safe, fast, and effective in the treatment of patients with SHD and refractory VTs.",
keywords = "Cardiac neuromodulation, Cardiac sympathetic denervation, Refractory ventricular arrhythmias, Stellate ganglion, Sympathicotomy, Ventricular tachycardia",
author = "Cauti, \{Filippo Maria\} and Pietro Rossi and Stefano Bianchi and Michele Magnocavallo and Silvia Capone and Rocca, \{Domenico Giovanni Della\} and Marco Polselli and Katia Bruno and Pierfrancesco Tozzi and Chiara Rossi and Jacopo Vannucci and Francesco Pugliese and Raffaele Quaglione and Federico Venuta and Marco Anile",
note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023.",
year = "2025",
month = mar,
doi = "10.1007/s10840-023-01706-6",
language = "English",
volume = "68",
pages = "391--399",
journal = "Journal of Interventional Cardiac Electrophysiology",
issn = "1383-875X",
publisher = "Springer Netherlands",
number = "2",
}