Arrhythmias & electrophysiology
Trigger Type and Breakthrough Cardiac Events in Inherited Arrhythmia Syndromes After Left Cardiac Sympathetic Denervation
Authors' conclusion
There is a marked pre-LCSD phenotypic determinant of LCSD's therapeutic efficacy. Independently from underlying genotype, patients with adrenergic triggers associated with their pre-LCSD symptoms had a greater reduction in disease-mediated BCEs.
Study context
- Population
- Previously symptomatic patients with long QT syndrome (LQTS) or catecholaminergic polymorphic ventricular tachycardia (CPVT) who underwent left cardiac sympathetic denervation (LCSD) at our institution since 2005LQTS 105 · CPVT 49
- Participants
- 154 pre-LCSD symptomatic patients
- Exposure
- non-AD triggered cardiac event (CE) vs adrenergic (AD)-triggered CE before LCSD, for risk of breakthrough cardiac events after LCSD
- non-AD triggered CEn = 56
- AD-triggered CEn = 98
- Outcome
- Patients with >1 BCE after LCSD
- Follow-up
- After LCSD: 5.9 ± 4.2 years
Methodological detailssingle institution
- Single institution
Main finding
As reported in the abstract
Patients with >1 BCE
49 patients
32%
Observational data: associations, not effects.
Further findings
Post-LCSD BCEs
- Post-LCSD breakthrough cardiac events (BCEs): P < 0.0001
BCEs, subset analysis: LQT1 patients with AD triggers
- Fewest BCEs in LQT1 patients with AD triggers, OR
- 0.24
- P
- P < 0.0001
BCEs in LQT2, LQT3, or LQT Minor patients with pre-LCSD AD-triggered CEs · To date
- No BCEs have occurred
Original publication
Trigger Type and Breakthrough Cardiac Events in Inherited Arrhythmia Syndromes After Left Cardiac Sympathetic Denervation. JACC Clin Electrophysiol. Published 23 April 2026. doi:10.
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