Arrhythmias & electrophysiologyCohort study

Trigger Type and Breakthrough Cardiac Events in Inherited Arrhythmia Syndromes After Left Cardiac Sympathetic Denervation

JACC Clin ElectrophysiolPublished

  • retrospective review
  • single institution

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
  • non-AD triggered CEn = 56
  • AD-triggered CEn = 98

Main finding

As reported in the abstract

Patients with >1 BCE after LCSD · follow-up after LCSD: 5.9 ± 4.2 years

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:10.1016/j.jacep.2026.03.019

Summarised from the published abstract; every number is checked against it