Effects on Repolarization Using Dynamic QT Interval Monitoring in Long‐QT Patients Following Left Cardiac Sympathetic Denervation. (8th February 2015)

• Record Type: Journal Article
• Authors: DESIMONE, CHRISTOPHER V.; BOS, J. MARTIJN; BOS, KATY M.; LIANG, JACKSON J.; PATEL, NIKHIL A.; HODGE, DAVID O.; NOHERIA, AMIT; ASIRVATHAM, SAMUEL J.; ACKERMAN, MICHAEL J.
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 26:Number 4(2015:Apr.)
• Page Start: 434
• Page End: 439
• Publication Date: 2015-02-08
• Subjects: Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.12609
• Languages: English
• ISSNs: 1045-3873

Abstract

<abstract abstract-type="main"> <title>Dynamic QT Interval Monitoring Post‐LCSD</title> <sec id="jce12609-sec-0010" sec-type="section"> <title>Background</title> <p>Videoscopic left cardiac sympathetic denervation (LCSD) is an adjunct therapy for reduction of arrhythmia‐induced events in patients with long‐QT syndrome (LQTS). LCSD reduces LQTS‐triggered breakthrough cardiac events. The temporal effects of QTc changes post‐LCSD have not been studied.</p> </sec> <sec id="jce12609-sec-0020" sec-type="section"> <title>Methods</title> <p>We utilized continuous QTc monitoring on 72 patients with LQTS. We evaluated acute and long‐term QTc changes in comparison to 12‐lead ECG‐derived QTc values prior to surgery, 24 hours postsurgery, and at follow up ≥3 months.</p> </sec> <sec id="jce12609-sec-0030" sec-type="section"> <title>Results</title> <p>Seventy‐two patients underwent LCSD at our institution (46% male, mean age at LCSD was 14 ± 10 years). The mean baseline, pre‐LCSD QTc was 505 ± 56 ms, which had decreased significantly at ≥3 months post‐LCSD to 491 ± 40 ms (P = 0.001). QTc monitoring revealed that the majority of the cohort (53/72; 74%) had a transient increase >30 ms in QTc from baseline, with an average maximum increase of 72 ± 30 ms. Resolution within 10 ms of baseline or less occurred in 57% (30/53) at 24 hours post‐LCSD.</p> </sec> <sec id="jce12609-sec-0040" sec-type="section"> <title>Conclusions</title> <p>Although LQTS patients may have a paradoxically increased QTc post‐LCSD, the effects are transient in most patients. Importantly, no patients experienced any arrhythmias in the postoperative setting related to this transient rise in QTc.</p> </sec> </abstract>