Abstract
Catheter-based renal sympathetic denervation may be an alternative after unsuccessful conventional ablation attempts.
Keywords: Tachycardia, Syncope
Dear Editor
We read the article by Sumitomo et al. [1] published recently in the Journal of Arrhythmia with great interest. In that review article, the authors discussed therapeutic options for catecholaminergic polymorphic ventricular tachycardia (CPVT). It is well known that CPVT is an inherited form of PVT associated with enhanced sympathetic nerve activity. As stated by the author, non-medication modalities may be necessary in some patients. As a percutaneous approach, Armaganijan et al. [2] recently studied the potential role of catheter-based renal sympathetic denervation (RSD) in patients with refractory ventricular arrhythmias. Similarly, we used the RSD technique in a 46-year-old man who was admitted to our clinic with electrical storm related to CPVT. After failed endo-epicardial ablation attempts, we decided to perform RSD. The EnSite Velocity three-dimensional mapping system was used to demonstrate the renal arteries. A steerable long sheath was placed at the ostium of the renal arteries by using the standard “over-the-wire” technique. Ablation was performed from distal to proximal with a non-irrigated ablation catheter. A total of 20 points were ablated with parameters of 5 W, 45 °C, and 20 s in each renal artery. Sinus rhythm was achieved immediately at the end of the procedure and no PVT episode was detected.
At this time, RSD is not accepted as a standard or preferred treatment technique for all CPVT cases. However, some ventricular arrhythmias do not respond to conventional ablation. Thus, RSD may be a potential alternative for patients in whom other ablative strategies were unsuccessful.
Conflict of interest
All authors declare no conflict of interest related to this study.
References
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