Quality of life after videoscopic left cardiac sympathetic denervation in patients with potentially life-threatening cardiac channelopathies/cardiomyopathies

Heart Rhythm. 2016 Jan;13(1):62-9. doi: 10.1016/j.hrthm.2015.09.001. Epub 2015 Sep 1.

Abstract

Background: Left cardiac sympathetic denervation (LCSD) provides an additive or potentially alternative treatment option for patients with life-threatening cardiac channelopathies/cardiomyopathies.

Objective: We sought to examine the effects of LCSD on quality of life (QOL).

Methods: From November 2005 to May 2013, 109 patients who underwent LCSD were subsequently sent postoperative QOL surveys.

Results: Of 109 patients, 8 (7%) could not be contacted. Of the remaining 101 patients, 62 returned surveys (response rate 61%). There were an average of 4.1 ± 1.8 self-reported side effects immediately after LCSD. The most common anticipated side effects included unilateral hand dryness, color or temperature variance between sides of the face, and abnormal sweating. Although parent-reported pediatric physical QOL scores were lower than national norms, there were no differences in psychosocial QOL or disability scores (P = .09 and .33, respectively). QOL scores for adult patients were not significantly different from a US normative sample. Adult LCSD patients reported less disability than a US normative sample (P < .01). There was no correlation between QOL scores and the presence of anticipated side effects. However, among the subset of pediatric patients who continued to receive ventricular fibrillation-terminating implantable cardioverter-defibrillator shocks after LCSD, there was a correlation between their disability scores and the number of reported shocks (Spearman correlation = 0.56). The majority of patients/parents reported that they were very or somewhat satisfied with their surgery (or their child's surgery) and would definitely or probably recommend LCSD to another patient.

Conclusion: Despite the anticipated side effects associated with LCSD, patients are satisfied with their surgery and indicate that they would recommend the surgery to another patient.

Keywords: CPVT; Left cardiac sympathetic denervation; Long QT syndrome; Quality of life; Sudden cardiac death.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control*
  • Female
  • Heart* / innervation
  • Heart* / physiopathology
  • Humans
  • Long QT Syndrome* / complications
  • Long QT Syndrome* / surgery
  • Male
  • Middle Aged
  • Patient Preference
  • Postoperative Complications / psychology*
  • Quality of Life*
  • Self Report
  • Sympathectomy* / adverse effects
  • Sympathectomy* / methods
  • Thoracic Surgery, Video-Assisted / methods
  • Treatment Outcome