Abstract
The primary aim of the present study was to investigate the short-term effects of surgical left cardiac sympathetic denervation (LCSD) on the QT interval and heart rate in patients with congenital long QT syndrome (LQTS). Left cardiac sympathetic denervation was performed in five LQTS patients who had a history of syncope. The patients’ 12-lead and 24-h Holter monitoring ECG was recorded 24 h before and 24 h after LCSD. Treadmill exercise tests were also performed before and 6 days after surgery to assess changes in heart rate and the QT interval after surgery. Left cardiac sympathetic denervation was successful in all patients. The mean value of the corrected QT interval (QTc) in the five patients decreased from 0.59 ± 0.05 to 0.48 ± 0.04 s (P = 0.006) immediately after the procedure and remained short (0.47 ± 0.04, P < 0.05) after a 21-month follow-up. The mean value of QTc on the 24-h Holter monitoring ECG also decreased in all patients (0.67 ± 0.07 vs 0.60 ± 0.05 s, P < 0.01). The mean, maximum, and minimum heart rate on the 24-h ECG remained unchanged (P > 0.05). The maximum heart rate during the exercise tests decreased from 162 ± 4 beats/min before surgery to 129 ± 10 beats/min (P < 0.01). The exercise-induced increase in QTc remained unchanged after the surgery (P > 0.05). Although four of the five patients were syncope-free until 21 months postoperatively, the remaining patient had a recurrence of syncope, requiring an increased dose of β blocker. These findings indicate that LCSD shortens QTc and diminishes the exercise-induced increase in heart rate whereas the resting heart rate and exercise-induced increase in QTc remain unchanged. These results may have implications for the effectiveness and limitations of LCSD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
PJ Schwartz SG Priori C Napolitano (2000) The long QT syndrome DP Zipes J Jalife (Eds) Cardiac electrophysiology: from cell to bedside EditionNumberthird Saunders Philadelphia 597–615
LX Wang (2003) ArticleTitleCongenital long QT syndrome: 50 years of electrophysiological research from cell to bedside Acta Cardiol 58 133–138
PJ Schwartz E Locati (1985) ArticleTitleThe idiopathic long QT syndrome. Pathogenetic mechanisms and therapy Eur Heart J 6 IssueIDs4 103–114
I Splawski J Shen KW Timothy MH Lehmann S Priori JL Robinson AJ Moss PJ Schwartz JA Towbin GM Vincent MT Keating (2000) ArticleTitleSpectrum of mutations in long QT syndrome genes: KVLQT1, HERG, SCN5A, KCNE1, and KCNE2 Circulation 102 1178–1185
AJ Moss W Zareba WJ Hall PJ Schwartz RS Crampton J Benhorin GM Vincent EH Locati SG Priori C Napolitano A Medina L Zhang JL Robinson K Timothy JA Towbin ML Andrews (2000) ArticleTitleEffectiveness and limitations of β-blocker therapy in congenital long QT syndrome Circulation 101 616–623
PJ Schwartz EH Locati AJ Moss RS Crampton R Trazzi U Ruberti (1991) ArticleTitleLeft cardiac sympathetic denervation in the therapy of congenital long QT syndrome: a worldwide report Circulation 84 503–511
C Li D Hu X Qin Y Li P Li W Liu Z Li L Li LX Wang (2004) ArticleTitleClinical features and management of congenital long QT syndrome: a report on 54 families from a national registry Heart Vessels 19 38–42
J Li LX Wang J Wang (2003) ArticleTitleVideo-assisted thoracoscopic sympathectomy for congenital long QT syndromes Pacing Clin Electrophysiol 26 870–873
PJ Schwartz SG Priori C Spazzolini AJ Moss GM Vincent C Napolitano I Denjoy P Guicheney G Breithardt MT Keating JA Towbin AH Beggs P Brink AAM Wilde L Toivonen W Zareba J Robinson KW Timothy V Corfield D Wattanasirichaigoon C Corbett W Haverkamp E Schulze-Bahr MH Lehmann K Schwartz P Coumel R Bloise (2001) ArticleTitleGenotype-phenotype correlation in the long QT syndrome. Gene-specific triggers for life-threatening arrhythmias Circulation 103 89–95
PJ Schwartz A Malliani (1975) ArticleTitleElectrical alternation of the T wave: clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long QT syndrome Am Heart J 89 45–50
RS Crampton (1979) ArticleTitlePreeminence of left stellate ganglion in the long QT syndrome Circulation 59 769–778
PJ Schwartz NG Snebold AM Brown (1976) ArticleTitleEffects of unilateral cardiac sympathetic denervation on the ventricular fibrillation threshold Am J Cardiol 37 1034–1040
PJ Schwartz RL Verrier B Lown (1977) ArticleTitleEffects of stellectomy and vagotomy on ventricular refractoriness Circ Res 40 536–540
PJ Schwartz HL Stone (1979) ArticleTitleEffects of unilateral stellectomy upon cardiac performance during exercise in dogs Circ Res 44 637–645
CE Conrath AAM Wilde RJE Jongbloed RJE Jongbloed M Alders IM van Langen JP van Tintelen PA Doevendans T Opthof (2002) ArticleTitleGender differences in the long QT syndrome: effects of β-adrenoceptor blockade Cardiovasc Res 53 770–776
M Cerrone C Spazzolini SG Priori (2002) ArticleTitleLeft cardiac sympathetic denervation in the management of the long QT syndrome. A worldwide survey Circulation 106 IssueIDs2 II–701
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, C., Hu, D., Shang, L. et al. Surgical left cardiac sympathetic denervation for long QT syndrome: effects on QT interval and heart rate. Heart Vessels 20, 137–141 (2005). https://doi.org/10.1007/s00380-005-0820-1
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00380-005-0820-1