{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:00:20Z","timestamp":1790758820639,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Videoscopic left cardiac sympathetic denervation (LCSD) is an effective antifibrillatory, minimally invasive therapy for patients with potentially life-threatening arrhythmia syndromes like long QT syndrome (LQTS). Although initially used primarily for treatment intensification following documented LQTS-associated breakthrough cardiac events while on beta-blockers, LCSD as 1-time monotherapy for certain patients with LQTS requires further evaluation. We are presenting our early experience with LCSD monotherapy for carefully selected patients with LQTS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Among the 1400 patients evaluated and treated for LQTS, a retrospective review was performed on the 204 patients with LQTS who underwent LCSD at our institution since 2005 to identify the patients where the LCSD served as stand-alone, monotherapy. Clinical data on symptomatic status before diagnosis, clinical, and genetic diagnosis, and breakthrough cardiac events after diagnosis were analyzed to determine efficacy of LCSD monotherapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Result:<\/jats:title>\n            <jats:p>Overall, 64 of 204 patients (31%) were treated with LCSD alone (37 [58%] female, mean QTc 466\u00b130 ms, 16 [25%] patients were symptomatic before diagnosis with a mean age at diagnosis 17.3\u00b111.8 years, 5 had [8%] \u22651 breakthrough cardiac event after diagnosis, and mean age at LCSD was 21.1\u00b111.4 years). The primary motivation for LCSD monotherapy was an unacceptable quality of life stemming from beta-blocker related side effects (ie, beta-blocker intolerance) in 56\/64 patients (88%). The underlying LQTS genotype was LQT1 in 36 (56%) and LQT2 in 20 (31%). There were no significant LCSD-related surgical complications. With a mean follow-up of 2.7\u00b12.4 years so far, only 3 patients have experienced a nonlethal, post-LCSD breakthrough cardiac event in 180 patient-years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>LCSD may be a safe and effective stand-alone therapy for select patients who do not tolerate beta-blockers. However, LCSD is not curative and patient selection will be critical when potentially considering LCSD as monotherapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.120.008830","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T07:08:51Z","timestamp":1605596931000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Left Cardiac Sympathetic Denervation Monotherapy in Patients With Congenital Long QT Syndrome"],"prefix":"10.1161","volume":"13","author":[{"given":"Talha","family":"Niaz","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic (T.N., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3635-2003","authenticated-orcid":true,"given":"J. Martijn","family":"Bos","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic (T.N., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN."},{"name":"Department of Molecular Pharmacology &amp; Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory) (J.M.B., K.B.S., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6087-0484","authenticated-orcid":true,"given":"Katrina B.","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Department of Molecular Pharmacology &amp; Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory) (J.M.B., K.B.S., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Moir","sequence":"additional","affiliation":[{"name":"Division of Heart Rhythm Services, Department of Cardiovascular Medicine (J.M.B., K.B.S., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic (T.N., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN."},{"name":"Department of Molecular Pharmacology &amp; Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory) (J.M.B., K.B.S., M.J.A.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","first-page":"656","article-title":"Rare cardiac arrhythmia of the pediatric age II, syncopal attacks due to paroxysmal ventricular fibrillation.","volume":"45","author":"Romano C","year":"1963","unstructured":"Romano, C, Gemme, G, Pongiglione, R. Rare cardiac arrhythmia of the pediatric age II, syncopal attacks due to paroxysmal ventricular fibrillation. La Clinica pediatrica. 1963;45:656\u2013683.","journal-title":"La Clinica pediatrica"},{"key":"e_1_3_5_3_2","first-page":"103","article-title":"A new familial cardiac syndrome in children.","volume":"54","author":"Ward OC","year":"1964","unstructured":"Ward, OC. A new familial cardiac syndrome in children. 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