Álvarez-Ortega Carolina, Gómez-Martínez Josué Daniel, Cardona-Gallardo María Alejandra, Torres-España Nicolás Felipe, Pava-Molano Luis Fernando, Sánchez-Ortiz Álvaro Ignacio, Velásquez-Galvis Mauricio
Fundación Valle del Lili, Centro de Investigaciones Clínicas Cali, Colombia.
Universidad Icesi, Facultad de Ciencias de la Salud Cali, Colombia.
Interv Cardiol. 2024 May 9;19:e06. doi: 10.15420/icr.2023.09. eCollection 2024.
Ventricular arrhythmias are a leading cause of sudden death. The objective of this study was to characterise the results of patients with ventricular arrhythmias refractory to standard medical management, undergoing Video-assisted thoracoscopic cardiac sympathetic denervation (VAT-CSD) during 2012-2022 in Cali, Colombia.
This was an observational retrospective study, using the Institutional General Thoracic Surgery Database for patient identification and retrospectively reviewing the clinical charts for data description and analysis.
Clinical records of 19 patients who underwent VAT-CSD for ventricular arrhythmia were analysed. The patients were predominantly male (73.7%) with an mean age of 62 years. Ischaemic heart disease was the main underlying condition (52.6%); all individuals had a diagnosis of heart failure, with comorbidities such as hypertension (63.1%), acute MI (57.8%) and diabetes (26.3%) also present. The procedure was performed bilaterally in 89.4% of cases and was successful with minimal perioperative complications. Postoperative follow-up showed improvement in symptoms, including a significant reduction in the number of ICD shocks and emergency department visits.
VAT-CSD is a viable, safe and palliative therapeutic option for patients with ventricular arrhythmias who have not responded to conventional treatments, achieving a significant decrease in symptoms with low mortality and perioperative complications.
室性心律失常是猝死的主要原因。本研究的目的是描述2012年至2022年在哥伦比亚卡利接受电视辅助胸腔镜心脏交感神经切除术（VAT-CSD）的难治性室性心律失常患者的治疗结果。
这是一项观察性回顾性研究，利用机构普通胸外科数据库识别患者，并回顾临床病历以进行数据描述和分析。
分析了19例接受VAT-CSD治疗室性心律失常患者的临床记录。患者以男性为主（73.7%），平均年龄62岁。缺血性心脏病是主要的基础疾病（52.6%）；所有患者均诊断为心力衰竭，还伴有高血压（63.1%）、急性心肌梗死（57.8%）和糖尿病（26.3%）等合并症。89.4%的病例双侧进行了该手术，手术成功，围手术期并发症极少。术后随访显示症状有所改善，包括植入式心律转复除颤器（ICD）电击次数和急诊就诊次数显著减少。
对于对传统治疗无反应的室性心律失常患者，VAT-CSD是一种可行、安全的姑息性治疗选择，可显著减轻症状，死亡率和围手术期并发症较低。
