Arrhythmias & electrophysiology
Neuromodulation for the Treatment of Refractory Ventricular Arrhythmias
Authors' conclusion
Autonomic neuromodulation with SGB, TcMS, or CSD in patients with AAD-refractory VAs is safe and results in substantial acute reduction of VA although recurrent arrhythmias are common, and not all patients experience a reduction in arrhythmia burden.
Study context
- Population
- Patients with antiarrhythmic drug-refractory ventricular arrhythmias, Hospital of the University of Pennsylvania, 2019–2021
- Participants
- 11 / 19 / 7
- Exposure
- Autonomic neuromodulation in AAD-refractory ventricular arrhythmias (VAs)
- Stellate ganglion blockade (SGB)n = 11
- Transcutaneous magnetic stimulation (TcMS)n = 19
- Cardiac sympathetic denervation (CSD)n = 7
- Outcome
- Episodes of sustained VAs, 24 h before vs 24 h after initial neuromodulation
- Follow-up
- 24 hours
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Before neuromodulation (median, IQR 4-12)
- 7
- After neuromodulation (median, IQR 0-1)
- 0
- Reduction in sustained VA episodes
- P < 0.001
Observational data: associations, not effects.
Further findings
Recurrent VAs · 1.2 ± 1.1 years of follow-up
- Patients with recurrent VAs
- 21 (62%)
- Median time to recurrence, days (IQR 1-25)
- 3
Outcomes by VA morphology
- Outcomes similar in monomorphic and polymorphic VAs
VA burden in patients with acute MI within 30 days before neuromodulation · 24 hours after treatment
- Episodes before (median, IQR 7-12)
- 11
- Episodes after
- 0
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Neuromodulation for the Treatment of Refractory Ventricular Arrhythmias. JACC Clin Electrophysiol. Published 26 October 2022. doi:10.
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