Catecholaminergic polymorphic ventricular tachycardia surgery: Difference between revisions

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==Overview==
==Overview==
Surgical intervention is not recommended for the management of [disease name].


OR
Surgery is not the first-line treatment option for patients with catecholaminergic polymorphic ventricular tachycardia. [[Sympathectomy]] is usually reserved for patients who experience recurrent [[symptoms]] and/or [[implantable cardioverter-defibrillator]] ([[ICD]]) shocks despite optimal medical therapy or in those who are intolerant or have contraindications to [[beta blockers]]


Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
==Surgery==
===Sympathectomy===
*Left [[cardiac]] [[sympathetic]] [[denervation]], where a portion of the [[sympathetic chain]] is [[surgical|surgically]] or [[endoscopic|endoscopically]] resected, and bilateral [[thoracoscopy|thoracoscopic]] [[sympathectomy]] have reported to be useful therapeutic methods for suppressing [[ventricular arrhythmias]] in [[CPVT]] patients.<ref name="PrioriBlomström-Lundqvist2015">{{cite journal|last1=Priori|first1=Silvia G.|last2=Blomström-Lundqvist|first2=Carina|last3=Mazzanti|first3=Andrea|last4=Blom|first4=Nico|last5=Borggrefe|first5=Martin|last6=Camm|first6=John|last7=Elliott|first7=Perry Mark|last8=Fitzsimons|first8=Donna|last9=Hatala|first9=Robert|last10=Hindricks|first10=Gerhard|last11=Kirchhof|first11=Paulus|last12=Kjeldsen|first12=Keld|last13=Kuck|first13=Karl-Heinz|last14=Hernandez-Madrid|first14=Antonio|last15=Nikolaou|first15=Nikolaos|last16=Norekvål|first16=Tone M.|last17=Spaulding|first17=Christian|last18=Van Veldhuisen|first18=Dirk J.|title=2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death|journal=European Heart Journal|volume=36|issue=41|year=2015|pages=2793–2867|issn=0195-668X|doi=10.1093/eurheartj/ehv316}}</ref><ref name="SchneiderSteinmetz2012">{{cite journal|last1=Schneider|first1=Heike E.|last2=Steinmetz|first2=Michael|last3=Krause|first3=Ulrich|last4=Kriebel|first4=Thomas|last5=Ruschewski|first5=Wolfgang|last6=Paul|first6=Thomas|title=Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome|journal=Clinical Research in Cardiology|volume=102|issue=1|year=2012|pages=33–42|issn=1861-0684|doi=10.1007/s00392-012-0492-7}}</ref><ref>{{cite journal|title=Successful treatment of catecholaminergic polymorphic ventricular tachycardia with bilateral thoracoscopic sympathectomy|journal=Heart Rhythm|date=October 2008|first=P.A.|last=Scott|coauthors=A.J. Sandilands, G.E. Morris, J.M. Morgan |volume=5|issue=10|pages=1461–1463|pmid=18760972 |url=|format=|doi=10.1016/j.hrthm.2008.07.007 }}</ref><ref name="ColluraJohnson2009">{{cite journal|last1=Collura|first1=Christopher A.|last2=Johnson|first2=Jonathan N.|last3=Moir|first3=Christopher|last4=Ackerman|first4=Michael J.|title=Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery|journal=Heart Rhythm|volume=6|issue=6|year=2009|pages=752–759|issn=15475271|doi=10.1016/j.hrthm.2009.03.024}}</ref>
*Indications:<ref name="PrioriBlomström-Lundqvist2015">{{cite journal|last1=Priori|first1=Silvia G.|last2=Blomström-Lundqvist|first2=Carina|last3=Mazzanti|first3=Andrea|last4=Blom|first4=Nico|last5=Borggrefe|first5=Martin|last6=Camm|first6=John|last7=Elliott|first7=Perry Mark|last8=Fitzsimons|first8=Donna|last9=Hatala|first9=Robert|last10=Hindricks|first10=Gerhard|last11=Kirchhof|first11=Paulus|last12=Kjeldsen|first12=Keld|last13=Kuck|first13=Karl-Heinz|last14=Hernandez-Madrid|first14=Antonio|last15=Nikolaou|first15=Nikolaos|last16=Norekvål|first16=Tone M.|last17=Spaulding|first17=Christian|last18=Van Veldhuisen|first18=Dirk J.|title=2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death|journal=European Heart Journal|volume=36|issue=41|year=2015|pages=2793–2867|issn=0195-668X|doi=10.1093/eurheartj/ehv316}}</ref><ref name="De FerrariDusi2015">{{cite journal|last1=De Ferrari|first1=Gaetano M.|last2=Dusi|first2=Veronica|last3=Spazzolini|first3=Carla|last4=Bos|first4=J. Martijn|last5=Abrams|first5=Dominic J.|last6=Berul|first6=Charles I.|last7=Crotti|first7=Lia|last8=Davis|first8=Andrew M.|last9=Eldar|first9=Michael|last10=Kharlap|first10=Maria|last11=Khoury|first11=Asaad|last12=Krahn|first12=Andrew D.|last13=Leenhardt|first13=Antoine|last14=Moir|first14=Christopher R.|last15=Odero|first15=Attilio|last16=Olde Nordkamp|first16=Louise|last17=Paul|first17=Thomas|last18=Rosés i Noguer|first18=Ferran|last19=Shkolnikova|first19=Maria|last20=Till|first20=Jan|last21=Wilde|first21=Arthur A.M.|last22=Ackerman|first22=Michael J.|last23=Schwartz|first23=Peter J.|title=Clinical Management of Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Circulation|volume=131|issue=25|year=2015|pages=2185–2193|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.115.015731}}</ref><ref name="WildeBhuiyan2008">{{cite journal|last1=Wilde|first1=Arthur A.M.|last2=Bhuiyan|first2=Zahurul A.|last3=Crotti|first3=Lia|last4=Facchini|first4=Mario|last5=De Ferrari|first5=Gaetano M.|last6=Paul|first6=Thomas|last7=Ferrandi|first7=Chiara|last8=Koolbergen|first8=Dave R.|last9=Odero|first9=Attilio|last10=Schwartz|first10=Peter J.|title=Left Cardiac Sympathetic Denervation for Catecholaminergic Polymorphic Ventricular Tachycardia|journal=New England Journal of Medicine|volume=358|issue=19|year=2008|pages=2024–2029|issn=0028-4793|doi=10.1056/NEJMoa0708006}}</ref>
**Patients who experience recurrent [[symptoms]] and/or [[implantable cardioverter-defibrillator]] ([[ICD]]) shocks despite optimal medical therapy
**Patients who are intolerant or have contraindications to [[beta blockers]]
*Limitations:
**Complexity of the surgical procedure
**Requirement of a specialised surgical centre
**Complications, such as:<ref name="Waddell-SmithErtresvaag2015">{{cite journal|last1=Waddell-Smith|first1=Kathryn E.|last2=Ertresvaag|first2=Kjetil N.|last3=Li|first3=Jian|last4=Chaudhuri|first4=Krish|last5=Crawford|first5=Jackie R.|last6=Hamill|first6=James K.|last7=Haydock|first7=David|last8=Skinner|first8=Jonathan R.|title=Physical and Psychological Consequences of Left Cardiac Sympathetic Denervation in Long-QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia|journal=Circulation: Arrhythmia and Electrophysiology|volume=8|issue=5|year=2015|pages=1151–1158|issn=1941-3149|doi=10.1161/CIRCEP.115.003159}}</ref>
***[[Horner's syndrome]]
***[[Pneumothorax]]
*In spite of the side-effects and complications, the procedure was safe and satisfactory among the vast majority of patients.


OR
===Catheter ablation===
*The onset of [[CPVT]] may be initiated from [[purkinje cells]] and successful [[catheter ablation]] has been reported.<ref name="PrioriWilde2013">{{cite journal|last1=Priori|first1=Silvia G.|last2=Wilde|first2=Arthur A.|last3=Horie|first3=Minoru|last4=Cho|first4=Yongkeun|last5=Behr|first5=Elijah R.|last6=Berul|first6=Charles|last7=Blom|first7=Nico|last8=Brugada|first8=Josep|last9=Chiang|first9=Chern-En|last10=Huikuri|first10=Heikki|last11=Kannankeril|first11=Prince|last12=Krahn|first12=Andrew|last13=Leenhardt|first13=Antoine|last14=Moss|first14=Arthur|last15=Schwartz|first15=Peter J.|last16=Shimizu|first16=Wataru|last17=Tomaselli|first17=Gordon|last18=Tracy|first18=Cynthia|last19=Ackerman|first19=Michael|last20=Belhassen|first20=Bernard|last21=Estes|first21=N. A. Mark|last22=Fatkin|first22=Diane|last23=Kalman|first23=Jonathan|last24=Kaufman|first24=Elizabeth|last25=Kirchhof|first25=Paulus|last26=Schulze-Bahr|first26=Eric|last27=Wolpert|first27=Christian|last28=Vohra|first28=Jitendra|last29=Refaat|first29=Marwan|last30=Etheridge|first30=Susan P.|last31=Campbell|first31=Robert M.|last32=Martin|first32=Edward T.|last33=Quek|first33=Swee Chye|title=Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes|journal=EP Europace|volume=15|issue=10|year=2013|pages=1389–1406|issn=1532-2092|doi=10.1093/europace/eut272}}</ref>
*[[Catheter ablation]] of the bidirectional [[VPC]]s that trigger [[VF]] has been reported and this procedure could become an adjunctive therapy in patients with refractory [[CPVT]].<ref name="KaneshiroNaruse2012">{{cite journal|last1=Kaneshiro|first1=Takashi|last2=Naruse|first2=Yoshihisa|last3=Nogami|first3=Akihiko|last4=Tada|first4=Hiroshi|last5=Yoshida|first5=Kentaro|last6=Sekiguchi|first6=Yukio|last7=Murakoshi|first7=Nobuyuki|last8=Kato|first8=Yoshiaki|last9=Horigome|first9=Hitoshi|last10=Kawamura|first10=Mihoko|last11=Horie|first11=Minoru|last12=Aonuma|first12=Kazutaka|title=
            Successful Catheter Ablation of Bidirectional Ventricular Premature Contractions Triggering Ventricular Fibrillation in Catecholaminergic Polymorphic Ventricular Tachycardia With
            RyR2
            Mutation
          |journal=Circulation: Arrhythmia and Electrophysiology|volume=5|issue=1|year=2012|issn=1941-3149|doi=10.1161/CIRCEP.111.966549}}</ref>
*Further evidence and experiences are required for its recommendation.


The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
== 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT)<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary|journal=Journal of the American College of Cardiology|volume=72|issue=14|year=2018|pages=1677–1749|issn=07351097|doi=10.1016/j.jacc.2017.10.053}}</ref> ==
 
OR
 
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
 
OR
 
Surgery is the mainstay of treatment for [disease or malignancy].
 
==Indications==
 
*Surgical intervention is not recommended for the management of [disease name].
OR
*Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
 
==Surgery==


*The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
{|class="wikitable"
OR
|-
*Surgery is the mainstay of treatment for [disease or malignancy].
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''In patients with catecholaminergic polymorphic ventricular tachycardia, a [[beta blocker]] is recommended.''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.'''In patients with catecholaminergic polymorphic ventricular tachycardia and recurrent sustained [[VT]] or [[syncope]], while receiving adequate or maximally tolerated [[beta blocker]], treatment intensification with either combination medication therapy (e.g., [[beta blocker]], [[flecainide]]), left cardiac sympathetic denervation, and/or an [[ICD]] is recommended ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}


==Contraindications==
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''In patients with catecholaminergic polymorphic ventricular tachycardia and with clinical [[VT]] or exceptional [[syncope]], [[genetic counseling]] and [[genetic testing]] are reasonable ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}


==References==
==References==

Latest revision as of 17:19, 24 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mounika Reddy Vadiyala, M.B.B.S.[2]

Overview

Surgery is not the first-line treatment option for patients with catecholaminergic polymorphic ventricular tachycardia. Sympathectomy is usually reserved for patients who experience recurrent symptoms and/or implantable cardioverter-defibrillator (ICD) shocks despite optimal medical therapy or in those who are intolerant or have contraindications to beta blockers

Surgery

Sympathectomy

Catheter ablation

  • The onset of CPVT may be initiated from purkinje cells and successful catheter ablation has been reported.[8]
  • Catheter ablation of the bidirectional VPCs that trigger VF has been reported and this procedure could become an adjunctive therapy in patients with refractory CPVT.[9]
  • Further evidence and experiences are required for its recommendation.

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT)[10]

Class I
"1.In patients with catecholaminergic polymorphic ventricular tachycardia, a beta blocker is recommended.(Level of Evidence: B)"
"2.In patients with catecholaminergic polymorphic ventricular tachycardia and recurrent sustained VT or syncope, while receiving adequate or maximally tolerated beta blocker, treatment intensification with either combination medication therapy (e.g., beta blocker, flecainide), left cardiac sympathetic denervation, and/or an ICD is recommended (Level of Evidence: B)"
Class IIa
"1.In patients with catecholaminergic polymorphic ventricular tachycardia and with clinical VT or exceptional syncope, genetic counseling and genetic testing are reasonable (Level of Evidence: B)"

References

  1. ↑ 1.0 1.1 Priori, Silvia G.; Blomström-Lundqvist, Carina; Mazzanti, Andrea; Blom, Nico; Borggrefe, Martin; Camm, John; Elliott, Perry Mark; Fitzsimons, Donna; Hatala, Robert; Hindricks, Gerhard; Kirchhof, Paulus; Kjeldsen, Keld; Kuck, Karl-Heinz; Hernandez-Madrid, Antonio; Nikolaou, Nikolaos; Norekvål, Tone M.; Spaulding, Christian; Van Veldhuisen, Dirk J. (2015). "2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death". European Heart Journal. 36 (41): 2793–2867. doi:10.1093/eurheartj/ehv316. ISSN 0195-668X.
  2. ↑ Schneider, Heike E.; Steinmetz, Michael; Krause, Ulrich; Kriebel, Thomas; Ruschewski, Wolfgang; Paul, Thomas (2012). "Left cardiac sympathetic denervation for the management of life-threatening ventricular tachyarrhythmias in young patients with catecholaminergic polymorphic ventricular tachycardia and long QT syndrome". Clinical Research in Cardiology. 102 (1): 33–42. doi:10.1007/s00392-012-0492-7. ISSN 1861-0684.
  3. ↑ Scott, P.A. (October 2008). "Successful treatment of catecholaminergic polymorphic ventricular tachycardia with bilateral thoracoscopic sympathectomy". Heart Rhythm. 5 (10): 1461–1463. doi:10.1016/j.hrthm.2008.07.007. PMID 18760972. Unknown parameter |coauthors= ignored (help)
  4. ↑ Collura, Christopher A.; Johnson, Jonathan N.; Moir, Christopher; Ackerman, Michael J. (2009). "Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery". Heart Rhythm. 6 (6): 752–759. doi:10.1016/j.hrthm.2009.03.024. ISSN 1547-5271.
  5. ↑ De Ferrari, Gaetano M.; Dusi, Veronica; Spazzolini, Carla; Bos, J. Martijn; Abrams, Dominic J.; Berul, Charles I.; Crotti, Lia; Davis, Andrew M.; Eldar, Michael; Kharlap, Maria; Khoury, Asaad; Krahn, Andrew D.; Leenhardt, Antoine; Moir, Christopher R.; Odero, Attilio; Olde Nordkamp, Louise; Paul, Thomas; Rosés i Noguer, Ferran; Shkolnikova, Maria; Till, Jan; Wilde, Arthur A.M.; Ackerman, Michael J.; Schwartz, Peter J. (2015). "Clinical Management of Catecholaminergic Polymorphic Ventricular Tachycardia". Circulation. 131 (25): 2185–2193. doi:10.1161/CIRCULATIONAHA.115.015731. ISSN 0009-7322.
  6. ↑ Wilde, Arthur A.M.; Bhuiyan, Zahurul A.; Crotti, Lia; Facchini, Mario; De Ferrari, Gaetano M.; Paul, Thomas; Ferrandi, Chiara; Koolbergen, Dave R.; Odero, Attilio; Schwartz, Peter J. (2008). "Left Cardiac Sympathetic Denervation for Catecholaminergic Polymorphic Ventricular Tachycardia". New England Journal of Medicine. 358 (19): 2024–2029. doi:10.1056/NEJMoa0708006. ISSN 0028-4793.
  7. ↑ Waddell-Smith, Kathryn E.; Ertresvaag, Kjetil N.; Li, Jian; Chaudhuri, Krish; Crawford, Jackie R.; Hamill, James K.; Haydock, David; Skinner, Jonathan R. (2015). "Physical and Psychological Consequences of Left Cardiac Sympathetic Denervation in Long-QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia". Circulation: Arrhythmia and Electrophysiology. 8 (5): 1151–1158. doi:10.1161/CIRCEP.115.003159. ISSN 1941-3149.
  8. ↑ Priori, Silvia G.; Wilde, Arthur A.; Horie, Minoru; Cho, Yongkeun; Behr, Elijah R.; Berul, Charles; Blom, Nico; Brugada, Josep; Chiang, Chern-En; Huikuri, Heikki; Kannankeril, Prince; Krahn, Andrew; Leenhardt, Antoine; Moss, Arthur; Schwartz, Peter J.; Shimizu, Wataru; Tomaselli, Gordon; Tracy, Cynthia; Ackerman, Michael; Belhassen, Bernard; Estes, N. A. Mark; Fatkin, Diane; Kalman, Jonathan; Kaufman, Elizabeth; Kirchhof, Paulus; Schulze-Bahr, Eric; Wolpert, Christian; Vohra, Jitendra; Refaat, Marwan; Etheridge, Susan P.; Campbell, Robert M.; Martin, Edward T.; Quek, Swee Chye (2013). "Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes". EP Europace. 15 (10): 1389–1406. doi:10.1093/europace/eut272. ISSN 1532-2092.
  9. ↑ Kaneshiro, Takashi; Naruse, Yoshihisa; Nogami, Akihiko; Tada, Hiroshi; Yoshida, Kentaro; Sekiguchi, Yukio; Murakoshi, Nobuyuki; Kato, Yoshiaki; Horigome, Hitoshi; Kawamura, Mihoko; Horie, Minoru; Aonuma, Kazutaka (2012). "Successful Catheter Ablation of Bidirectional Ventricular Premature Contractions Triggering Ventricular Fibrillation in Catecholaminergic Polymorphic Ventricular Tachycardia With RyR2 Mutation". Circulation: Arrhythmia and Electrophysiology. 5 (1). doi:10.1161/CIRCEP.111.966549. ISSN 1941-3149. line feed character in |title= at position 179 (help)
  10. ↑ Al-Khatib, Sana M.; Stevenson, William G.; Ackerman, Michael J.; Bryant, William J.; Callans, David J.; Curtis, Anne B.; Deal, Barbara J.; Dickfeld, Timm; Field, Michael E.; Fonarow, Gregg C.; Gillis, Anne M.; Granger, Christopher B.; Hammill, Stephen C.; Hlatky, Mark A.; Joglar, José A.; Kay, G. Neal; Matlock, Daniel D.; Myerburg, Robert J.; Page, Richard L. (2018). "2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary". Journal of the American College of Cardiology. 72 (14): 1677–1749. doi:10.1016/j.jacc.2017.10.053. ISSN 0735-1097.

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