BACKGROUND: @entity1165 ( @entity1165 ) is a @entity74 causing life-threatening @entity943 whenever sympathetic activity increases. b-  lockers are the mainstay of therapy; when they fail, @entity737 ( @entity737 ) are used but often cause multiple shocks. Preliminary results with @entity6237 appear encouraging. We proposed left cardiac sympathetic denervation (LCSD) as useful additional therapy, but evidence remains anecdotal. METHODS AND RESULTS: We report 63 @entity1 with @entity1165 who underwent LCSD as secondary (n=54) or primary (n=9) prevention. The median post-LCSD follow-up was 37 months. The 9 asymptomatic @entity1 remained free of major @entity299 . Of the 54 @entity1 with prior major @entity299 either on (n=38) or off (n=16) optimal medical therapy, 13 (24%) had at least 1 recurrence: 0 @entity1 had an aborted @entity1167 , 2 @entity1 had @entity1163 only, 10 @entity1 had >= 1 appropriate @entity1479 discharges, and 1 @entity1 died suddenly. The 1- and 2-year cumulative event-free survival rates were 87% and 81%. The percentage of @entity1 with major @entity299 despite optimal medical therapy (n=38) was reduced from 100% to 32% (P<0.001) after LCSD, and among 29 @entity1 with a presurgical @entity1479 , the rate of shocks dropped by 93% from 3.6 to 0.6 shocks per @entity1 per year (P<0.001). @entity1 with an incomplete LCSD (n=7) were more likely to experience major @entity299 after LCSD (71% versus 17%; P<0.01) than those with a complete LCSD. CONCLUSIONS: LCSD is an effective antifibrillatory intervention for @entity1 with @entity1165 . Whenever @entity1163 occurs despite optimal medical therapy, LCSD could be considered the next step rather than an @entity1479 and could complement @entity737 in @entity1 with recurrent shocks.

Clinical Management of Catecholaminergic Polymorphic XXXX : The Role of Left Cardiac Sympathetic Denervation.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'person'] @entity1479 :: ('OMIM:252500', 'Disease') :: ['ICD'] @entity1165 :: ('MESH:D017180', 'Disease') :: ['CPVT', 'Catecholaminergic polymorphic ventricular tachycardia'] @entity1163 :: ('MESH:D013575', 'Disease') :: ['syncope'] @entity737 :: ('MESH:D057873', 'Disease') :: ['implantable cardioverter-defibrillators', 'ICDs'] @entity6237 :: ('MESH:D005424', 'Chemical') :: ['flecainide'] @entity74 :: ('MESH:D030342', 'Disease') :: ['genetic disorder'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac events'] @entity1167 :: ('MESH:D006323', 'Disease') :: ['cardiac arrest'] @entity943 :: ('MESH:D001145', 'Disease') :: ['arrhythmias']
@entity1165 :: (MESH:D017180,Disease) :: ['Ventricular Tachycardia']
