Arrhythmias & electrophysiologyCohort study
How Many Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Patients Need an Implantable Cardioverter-defibrillator (ICD)?
- retrospective study
- worldwide
Authors' conclusion
Our data suggest that probably <5% of symptomatic CPVT patients compliant to medical therapy require an ICD after LCSD. ICDs do not reliably prevent SCD.
Study context
- Population
- CPVT patients who underwent left cardiac sympathetic denervation (LCSD) (51% female, 80% probands, 79% RYR2 positive)CPVT patients who underwent LCSD, main subanalysis n = 118 (symptomatic without a high-risk genotype and compliant to therapy), of whom 41 had syncope on medical therapy · main subanalysis 118 · syncope on medical therapy (of the 118) 41
- Participants
- 162 patients
Main finding
As reported in the abstract
≥1 CE after LCSD · median of 48 months (Q1-Q3: 12-111 months) after LCSD
LCSD
17%
28 of 162 of 162
- of the 28 with cardiac events (CEs), during noncompliance
- 10 of 28 (36%)
Observational data: associations, not effects.
Further findings
CEs after LCSD, main subanalysis (n = 118)
- CEs after LCSD among the 118
- 13%
- 3 sudden cardiac arrest (SCAs) and 1 sudden cardiac death (SCD) despite an ICD among the 118
- 3%
CEs after LCSD, those with syncope on medical therapy (n = 41)
- CEs after LCSD among the 41
- 6 (15%)
- including the SCD despite an ICD
- 3%
ICD shocks and electrical storms
- reduction in ICD shocks
- 67%
- reduction in electrical storms
- 80%
Baseline before LCSD
- ≥1 CE before LCSD
- n = 139; 85%
- CEs despite medical therapy
- 84 (52%)
- previous SCA
- 43 (27%)
- received a beta-blocker
- 93%
- beta-blocker nonselective
- 85%
- both a beta-blocker and a class I antiarrhythmic drug
- 53%
- ICD before LCSD
- 55% (89)
Original publication
How Many CPVT Patients Need an ICD? JACC Clin Electrophysiol. Published 14 May 2026. doi:10.1016/j.jacep.2026.03.027
Summarised from the published abstract; every number is checked against it