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Bilateral thoracoscopic cervical sympathectomy for the treatment of recurrent polymorphic ventricular tachycardia

A J Turley, J Thambyrajah, A A Harcombe

Cardiothoracic Division, The James Cook University Hospital, Middlesbrough, UK

Correspondence to:
Correspondence to:
Dr Andrew J Turley
Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK; andrew.turley{at}stees.nhs.uk

Congenital long QT syndrome (LQTS) is a disorder of prolonged cardiac repolarisation, manifest by a prolonged QT interval and characterised by recurrent presyncope/syncope, polymorphic ventricular tachycardia (PMVT), or sudden cardiac death. A 46 year old woman with no family history of sudden death or deafness presented with recurrent syncope. Physical examination and electrolytes were normal and a 12 lead ECG showed a corrected QT interval of 458 ms. A monitored syncopal episode documented PMVT. Despite potassium and magnesium supplements, ß blockade, implantation of a single then dual chamber implantable cardioverter defibrillator (ICD), amiodarone, nicorandil, and mexiletine, the patient continued to experience arrhythmia storms, receiving more than 700 ICD discharges over seven months. She was ultimately treated successfully with bilateral thoracoscopic cervicothoracic sympathectomies. This is the first reported bilateral thoracoscopic treatment of a patient with LQTS and symptomatic life threatening ventricular tachyarrhythmias refractory to current pharmacological and pacing techniques.

Abbreviations: ICD, implantable cardioverter defibrillator; LQTS, long QT syndrome; PMVT, polymorphic ventricular tachycardia

Keywords: long QT syndrome; polymorphic ventricular tachycardia; stellate ganglion blockade; thoracoscopic sympathectomy

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This article has been cited by other articles:

• Vincent, G. M. (2008). Genotyping Has a Minor Role in Selecting Therapy for Congenital Long-QT Syndromes at Present. Circ Arrhythm Electrophysiol 1: 227-233 [Full Text]  

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Bilateral thoracoscopic cervical sympathectomy for the treatment of recurrent polymorphic ventricula

Andrew J Turley, et al.

Online, 2 Aug 2005 [Full text]