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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Long-term outcome after thoracoscopic cardiac sympathectomy for refractory ventricular tachyarrhythmia storm
  1. Sanjeet Kumar Rai1,
  2. Mufaddal Khuzema Kazi2,
  3. Nitish Naik3 and
  4. Vuthaluru Seenu4
  1. 1 Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  2. 2 Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
  3. 3 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  4. 4 Department of General Surgery, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Professor Vuthaluru Seenu; seenuneilu04{at}gmail.com

Abstract

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.

  • Arrhythmias
  • Cardiothoracic surgery
  • General surgery

https://doi.org/10.1136/bcr-2022-248759

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    Footnotes

    • Contributors Patient primarily admitted under NN for medical management. Surgical intervention and management by VS and MK. SKR drafted the initial manuscript and reviewed the literature. NN and VS finalised the manuscript and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.