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.