A case of dilated cardiomyopathy successfully managing refractory electrical storm through sympathetic modulation

Q4 Medicine

Journal of Cardiology Cases Pub Date : 2025-03-01 DOI:10.1016/j.jccase.2024.11.008

Phuong Ngo Thanh Nguyen MD , Akiko Ueda MD , Yumi Katsume MD , Noriko Nonoguchi MD , Takato Mohri MD , Yoshifumi Hirata MD , Haruhiko Kondo MD , Kunitaro Watanabe MD , Kyoko Soejima MD

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Abstract

Recent research has demonstrated the effectiveness of cardiac sympathetic denervation in treating ventricular arrhythmias. We present a patient with dilated cardiomyopathy characterized by ventricular tachycardia (VT) resistant to standard treatments. Repeated left-sided stellate ganglion blocks provided temporary relief, followed by a thoracoscopic sympathectomy with T2–4 ganglionectomy, which significantly reduced the burden of VT. This intervention also allowed for the gradual reduction of antiarrhythmics. During the course of the hospital stay, the patient's activities of daily living steadily improved. Approximately one month following the surgical surgery, the patient was successfully discharged with a reduced burden of VT.

Learning objective

Evaluate the efficacy of cardiac sympathetic denervation (CSD) and ganglionectomy in treating refractory ventricular tachycardia in patients with dilated cardiomyopathy. Identify the potential advantages of CSD and ganglionectomy in avoiding the necessity for therapeutic escalation in refractory ventricular tachycardia cases.

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