Long-term outcome after thoracoscopic cardiac sympathectomy for refractory ventricular tachyarrhythmia storm

A man in his 40s presented with an acute anterior wall myocardial infarction (MI) 6 hours after symptom onset to a non-percutaneous intervention enabled hospital and underwent thrombolysis with tenecteplase. His chest pain resolved post-thrombolysis although ST segment resolution was less than 50%....

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Bibliographic Details
Published in:BMJ case reports 2022-03, Vol.15 (3), p.e248759
Main Authors: Rai, Sanjeet Kumar, Kazi, Mufaddal Khuzema, Naik, Nitish, Seenu, Vuthaluru
Format: Article
Language:English
Subjects:
Case Reports: Novel treatment (new drug/interventions
established drug/procedure in new situation)
Heart
Humans
Male
Myocardial Infarction - surgery
Sympathectomy - methods
Tachycardia, Ventricular - surgery
Ventricular Fibrillation - surgery
Citations: Items that this one cites
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Summary:A man in his 40s presented with an acute anterior wall myocardial infarction (MI) 6 hours after symptom onset to a non-percutaneous intervention enabled hospital and underwent thrombolysis with tenecteplase. His chest pain resolved post-thrombolysis although ST segment resolution was less than 50%. He had an episode of sustained ventricular tachycardia (VT) 48 hours after MI which was successfully cardioverted with 150 J biphasic shock. A month later he presented with a ventricular tachycardia storm that was refractory to pharmacological management. He underwent radiofrequency ablation of the VT using three-dimensional mapping. Although the patient remained free of VT/ventricular fibrillation (VF) for 48 hours, he had an episode of VF subsequently. A decision for bilateral surgical video assisted thoracoscopic cardiac sympathetic denervation was taken and the patient remained free of ventricular tachyarrhythmias after the procedure until.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2022-248759