Other Alternative Treatments for Challenging VTs
The sympathetic nervous system plays an important role in the genesis of ventricular arrhythmias. Cardiac sympathetic denervation (CSD) has been emerged as an important adjunctive therapy in the management of patients with treatment resistant VTs. CSD could reduce VT burden and decrease ICD shocks in patients with refractory VT.(29) However, CSD was performed more often in patients with channelopathy such as long QT syndrome and catecholaminergic polymorphic VT, data on CSD in structural heart disease is still limited, and the post-operation complications are still relatively high.(30)
More recently, Phillip S. and his colleagues reported that their novel noninvasive electrophysiology-guided radioablation could reduce the burden of VT and ICD shocks dramatically in 5 patients with refractory VTs.(31) However, this noninvasive treatment workflow is very complex, and a specific electrocardiographic mapping system is needed. Furthermore, this radiotherapy equipment has not been launched in market.