Journal of Arrhythmia 33 (2017) 245
Contents lists available at ScienceDirect
Journal of Arrhythmia journal homepage: www.elsevier.com/locate/joa
Letter to the Editor
Percutaneous renal sympathetic denervation in catecholaminergic polymorphic ventricular tachycardia Tolga Aksu, MDn, Erdem Guler, MD Derince Education and Research Hospital Department of Cardiology, 41500 Kocaeli, Turkey
art ic l e i nf o
a b s t r a c t
Article history: Received 16 November 2016 Received in revised form 9 December 2016 Accepted 22 December 2016 Available online 28 January 2017
Catheter-based renal sympathetic denervation may be an alternative after unsuccessful conventional ablation attempts. & 2017 Japanese Heart Rhythm Society. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Tachycardia Syncope
Dear Editor We read the article by Sumitomo et al. [1] published recently in the Journal of Arrhythmia with great interest. In that review article, the authors discussed therapeutic options for catecholaminergic polymorphic ventricular tachycardia (CPVT). It is well known that CPVT is an inherited form of PVT associated with enhanced sympathetic nerve activity. As stated by the author, non-medication modalities may be necessary in some patients. As a percutaneous approach, Armaganijan et al. [2] recently studied the potential role of catheter-based renal sympathetic denervation (RSD) in patients with refractory ventricular arrhythmias. Similarly, we used the RSD technique in a 46-year-old man who was admitted to our clinic with electrical storm related to CPVT. After failed endoepicardial ablation attempts, we decided to perform RSD. The EnSite Velocity three-dimensional mapping system was used to demonstrate the renal arteries. A steerable long sheath was placed at the ostium of the renal arteries by using the standard “over-thewire” technique. Ablation was performed from distal to proximal with a non-irrigated ablation catheter. A total of 20 points were ablated with parameters of 5 W, 45 °C, and 20 s in each renal artery. Sinus rhythm was achieved immediately at the end of the procedure and no PVT episode was detected.
n
At this time, RSD is not accepted as a standard or preferred treatment technique for all CPVT cases. However, some ventricular arrhythmias do not respond to conventional ablation. Thus, RSD may be a potential alternative for patients in whom other ablative strategies were unsuccessful.
Conflict of interest All authors declare no conflict of interest related to this study.
References [1] Sumitomo N. Current topics in catecholaminergic polymorphic ventricular tachycardia. J Arrhythm 2016;32:344–51. [2] Armaganijan LV, Staico R, Moreira DA, et al. 6-Month outcomes in patients with implantable cardioverter-defibrillators undergoing renal sympathetic denervation for the treatment of refractory ventricular arrhythmias. JACC Cardiovasc Interv 2015;8:984–90.
Corresponding author. Fax: þ 90 262 317 80 00. E-mail address: [email protected] (T. Aksu).
http://dx.doi.org/10.1016/j.joa.2016.12.004 1880-4276/& 2017 Japanese Heart Rhythm Society. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Contents lists available at ScienceDirect
Journal of Arrhythmia journal homepage: www.elsevier.com/locate/joa
Letter to the Editor
Percutaneous renal sympathetic denervation in catecholaminergic polymorphic ventricular tachycardia Tolga Aksu, MDn, Erdem Guler, MD Derince Education and Research Hospital Department of Cardiology, 41500 Kocaeli, Turkey
art ic l e i nf o
a b s t r a c t
Article history: Received 16 November 2016 Received in revised form 9 December 2016 Accepted 22 December 2016 Available online 28 January 2017
Catheter-based renal sympathetic denervation may be an alternative after unsuccessful conventional ablation attempts. & 2017 Japanese Heart Rhythm Society. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Tachycardia Syncope
Dear Editor We read the article by Sumitomo et al. [1] published recently in the Journal of Arrhythmia with great interest. In that review article, the authors discussed therapeutic options for catecholaminergic polymorphic ventricular tachycardia (CPVT). It is well known that CPVT is an inherited form of PVT associated with enhanced sympathetic nerve activity. As stated by the author, non-medication modalities may be necessary in some patients. As a percutaneous approach, Armaganijan et al. [2] recently studied the potential role of catheter-based renal sympathetic denervation (RSD) in patients with refractory ventricular arrhythmias. Similarly, we used the RSD technique in a 46-year-old man who was admitted to our clinic with electrical storm related to CPVT. After failed endoepicardial ablation attempts, we decided to perform RSD. The EnSite Velocity three-dimensional mapping system was used to demonstrate the renal arteries. A steerable long sheath was placed at the ostium of the renal arteries by using the standard “over-thewire” technique. Ablation was performed from distal to proximal with a non-irrigated ablation catheter. A total of 20 points were ablated with parameters of 5 W, 45 °C, and 20 s in each renal artery. Sinus rhythm was achieved immediately at the end of the procedure and no PVT episode was detected.
n
At this time, RSD is not accepted as a standard or preferred treatment technique for all CPVT cases. However, some ventricular arrhythmias do not respond to conventional ablation. Thus, RSD may be a potential alternative for patients in whom other ablative strategies were unsuccessful.
Conflict of interest All authors declare no conflict of interest related to this study.
References [1] Sumitomo N. Current topics in catecholaminergic polymorphic ventricular tachycardia. J Arrhythm 2016;32:344–51. [2] Armaganijan LV, Staico R, Moreira DA, et al. 6-Month outcomes in patients with implantable cardioverter-defibrillators undergoing renal sympathetic denervation for the treatment of refractory ventricular arrhythmias. JACC Cardiovasc Interv 2015;8:984–90.
Corresponding author. Fax: þ 90 262 317 80 00. E-mail address: [email protected] (T. Aksu).
http://dx.doi.org/10.1016/j.joa.2016.12.004 1880-4276/& 2017 Japanese Heart Rhythm Society. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
