Left sympathetic denervation as an effective therapy in a young patient with long QT syndrome

Abstract

Long QT syndrome (LQTS) is a rare inherited cardiac channelopathy with an abnormally prolonged QT interval with an increased predisposition for fatal ventricular arrhythmias in the presence of a structurally normal heart. Beta-blockers are the treatment of choice and are successful in 75%–80% of patients. Although beta-blocker therapy significantly reduces the risk of sudden cardiac death (SCD) in this population, it is not completely protective, and cardiac events still occur. Implantable cardioverter-defibrillator (ICD) therapy is highly successful in preventing SCD in high-risk LQTS patients. However, it is not without complications, especially in children and young adults, in whom the initial decision to implant an ICD carries long-term implications. In this subgroup of patients, the left cardiac sympathetic denervation showed promising evidence. Here, we describe a case of a 19-year-old female with refractory ventricular tachycardia due to LQTS, successfully managed by the left cardiac sympathetic denervation and beta-blockers alone.