R&D News: UCLA study assesses the impact of BCSD to control arrhythmias
The study found that surgery to snip nerves associated with the sympathetic nervous system on both the left and right sides of the chest may be helpful in stopping dangerous, incessant ventricular arrhythmias - known as an electrical storm - when other treatment methods have failed.
Kalyanam Shivkumar, studyâ€™s senior author, said: â€œWhen these treatment options fail, especially for a patient experiencing a life-threatening electrical storm, the situation becomes critical. We are always seeking additional options to help patients.â€
Mr Shivkumar noted that this research may provide a unique opportunity; if snipping the cardiac sympathetic nerve proves to effectively alleviate irregular heart rhythms, perhaps the treatment could be initiated early, before the condition manifests itself.
During the procedure, surgeons cut the stellate ganglia. To help control arrhythmias, surgeons snip the stellate ganglion, as well as the three ganglia directly below it, to completely remove the nerves destined for the heart. The procedure can be done on the left, on the right or on both sides of the thorax.
For the study, researchers reviewed records from patients at UCLA and a collaborating center in France. The patients all presented with electrical storms. Their average age was 60.
Researchers found that after the surgery, four of the six patients responded completely, with no more arrhythmias. One patient had a partial response, and one had no response at all.
With their heart rhythms stabilized, three of the responding patients received no more shocks from their defibrillators, which would previously occur when the devices tried to normalize irregular rhythms. One of these patients had been experiencing approximately 11 shocks a day. The patient who partially responded to treatment had a shock reduction of more than 50 percent.
All five responding patients survived until hospital discharge; two died after discharge as a result of health issues not related to arrhythmias. No major operative complications occurred in the patients studied, and typical side-effects related to the procedure, such as alterations in sweating or temperature regulation, were not significant.
Researchers noted that such side-effects are usually acceptable to seriously ill patients experiencing an electrical storm, considering that the alternatives include continued arrhythmias, defibrillator shocks or death.
According to the researchers, cutting the cardiac sympathetic nerve may interrupt pro-arrhythmic signaling within the heart tissue or stellate ganglion, thus stopping the irregular heart rhythms.
â€œWe are encouraged by this small studyâ€™s results and plan to further examine the role of this procedure in suppressing arrhythmias in a larger patient population,â€ said Olujimi Ajijola, lead author of the study.
â€œThis type of innovative therapy is only possible because of close scientific and clinical collaborations between multiple teams of specialists caring for very sick patients,â€ said co-author Aman Mahajan.
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