Minimally invasive VATS-LCSD helps children with refractory ventricular arrhythmias

Arrhythmias gone in majority of children, says study to be reported at 93rd AATS Annual Meeting

2013-05-08

(Press-News.org) Minneapolis, MN, May 7, 2013 - Inherited ventricular arrhythmias are an important cause of morbidity and sudden cardiac death in children who have structurally normal hearts. Despite conventional medical therapy, some of these children remain symptomatic with recurrent life-threatening arrhythmias, syncope, or frequent discharges from implantable cardioverter defibrillators (ICDs). Video-assisted thoracoscopic left cardiac sympathetic denervation (VATS-LCSD) is a minimally invasive procedure that can help many of these children with refractory cardiac arrhythmias. The results of a single-center experience with VATS-LCSD will be presented during the Congenital Heart Disease Session of the 93rd AATS Annual Meeting in Minneapolis by Dr. Sophie C. Hofferberth, MBBS.

"Existing treatments for inherited arrhythmias are often poorly tolerated or leave patients with ongoing symptoms and risk of sudden death. We have shown that VATS-LCSD is safe and should be considered as part of the treatment approach in all patients with ventricular arrhythmias," comments lead investigator Dr. Francis Fynn-Thompson, who is affiliated with the Department of Cardiac Surgery at Boston Children's Hospital.

This was a retrospective study of 24 patients who had undergone VATS-LCSD between August 2005 and December 2011. Of the 24 patients, 13 presented with congenital Long QT syndrome (LQTS), 9 with catecholaminergic polymorphic ventricular tachycardia (CPVT), and 2 with idiopathic recalcitrant ventricular tachycardia (VT). Eight patients also were implanted with an ICD device at the same time as undergoing the sympathetic denervation.

Almost three-quarters of symptomatic patients responded well to the treatment, and 55% of 22 patients became arrhythmia-free after sympathectomy. Good results were found in patients who were treated after experiencing multiple ICD discharges despite optimal medical therapy and those who had persistent symptoms despite medical therapy.

For patients who were unable to tolerate medical therapy, three of four showed excellent improvement. "Adjunctive VATS-LCSD appears to be a promising strategy for this subgroup of patients to be maintained at a lower medication dose and still remain symptom-free." In fact, anti-arrhythmic medications may be discontinued entirely for some patients after the procedure, says Dr. Fynn-Thompson.

Two patients underwent the procedure because they were at high risk of developing fatal arrhythmias. These children did not benefit from the procedure, and the authors believe it should not be used as a prophylactic measure.

Postoperative complications were minor. Eleven patients were initially managed in the ICU, and children generally left the hospital within 1-2 days. ### END

ELSE PRESS RELEASES FROM THIS DATE:

1 big European family

2013-05-08

From Ireland to the Balkans, Europeans are all closely related according to a new study of the DNA of people from across the continent. The study, conducted by Graham Coop at the University of California, Davis, and Peter Ralph of the University of Southern California, examined relatedness among Europeans up to about 3,000 years ago, comparing genetic sequences from over 2,000 individuals. Their results are published 7 May in the open access journal PLOS Biology. The researchers found that the extent to which two people are related tends to be smaller the farther apart ...

Older people in Africa have limited functional ability

2013-05-08

Many adults 45 years and older in Africa have limited functional ability The number of adults living into older age in sub-Saharan Africa is rapidly growing yet many older men and women will have an illness or disability that limits their ability to function, according to a study by researchers from the US and Malawi published in this week's PLOS Medicine. The researchers, led by Collin Payne from the University of Pennsylvania, also show that remaining life spent with severe limitations at age 45 in a sub Saharan African setting (Malawi) is comparable to that of 80-year-olds ...

Link between intimate partner violence and depression

2013-05-08

Not only are women who have experienced violence from their partner (intimate partner violence) at higher risk of becoming depressed, but women who are depressed may also be at increased risk of experiencing intimate partner violence, according to a study by international researchers published in this week's PLOS Medicine. Furthermore, there may also be a link between intimate partner violence and subsequent suicide among women, but little evidence to support a similar finding in men. The researchers led by Karen Devries from the London School of Hygiene & Tropical ...

Antimicrobial resistance in Vietnam

2013-05-08

Heiman Wertheim and Arjun Chandna from Oxford University and colleagues describe the launch and impact of VINARES, an initiative to strengthen antimicrobial stewardship in Viet Nam, which may be instructive for other countries struggling to address the threat of antimicrobial resistance. Antimicrobial resistance is increasingly recognised as a serious contemporary global health threat (with numerous calls for action from the international community), but while interventions to control antimicrobial resistance are available, implementation is developing countries (where ...

PLOS Collection assesses measurement of health interventions for women and children in LMICs

2013-05-08

New PLOS Collection assesses the measurement of whether much needed health interventions are reaching women and children across the developing world Measuring coverage of maternal, newborn and child health in low- and middle-income countries is critical to ensuring that health interventions are reaching the women and children who need them most, says a new Collection of articles published by PLOS this week. Accurate measurement of the effectiveness of those interventions for combatting diseases such as pneumonia and malaria, and preventing the transmission of HIV from ...

Study evaluates effect of increasing detection intervals in implantable cardioverter-defibrillators

2013-05-08

Programming an implantable cardioverter-defibrillator (ICD) with a long-detection interval compared with a standard-detection interval resulted in a reduction in anti-tachycardia pacing episodes, ICD shocks delivered, and inappropriate shocks, according to a study in the May 8 issue of JAMA. "Therapy with ICDs is now the standard of care in primary and secondary prevention. As indications for implants have expanded, concern about possible adverse effects of ICD therapies on prognosis and quality of life has arisen. Several authors have reported that ICD therapies, both ...

Genetic variations associated with susceptibility to bacteria linked to stomach disorders

2013-05-08

Two genome-wide association studies and a subsequent meta-analysis have found that certain genetic variations are associated with susceptibility to Helicobacter pylori, a bacteria that is a major cause of gastritis and stomach ulcers and is linked to stomach cancer, findings that may help explain some of the observed variation in individual risk for H pylori infection, according to a study in the May 8 issue of JAMA. "[H pylori] is the major cause of gastritis (80 percent) and gastroduodenal ulcer disease (15 percent-20 percent) and the only bacterial pathogen believed ...

Study finds increase in fall-related traumatic brain injuries among elderly men and women

2013-05-08

"Traumatic brain injury (TBI) is a major cause of hospitalization, disability, and death-worldwide, and among older adults, falling is the most common cause of TBI," writes Niina Korhonen, B.M., of the Injury and Osteoporosis Research Center, Tampere, Finland, and colleagues in a Research Letter. The authors previously reported that the number and incidence of adults 80 years of age or older admitted to the hospital due to fall-induced TBI in Finland increased from 1970 through 1999. This analysis is a follow-up of this population through 2011. The study included data ...

Theta brainwaves reflect ability to beat built-in bias

2013-05-08

PROVIDENCE, R.I. [Brown University] — Vertebrates are predisposed to act to gain rewards, and to lay low to avoid punishment. Try to teach chickens to back away from food in order to obtain it, and you'll fail, as researchers did in 1986. But (some) humans are better thinkers than chickens. In the May 8 edition of the Journal of Neuroscience, researchers show that the level of theta brainwave activity in the prefrontal cortex predicts whether people will be able to overcome these ingrained biases when doing so is required to achieve a goal. The study helps explain a distinctly ...

Rats take high-speed multisensory snapshots

2013-05-08

Cold Spring Harbor, N.Y. – When animals are on the hunt for food they likely use many senses, and scientists have wondered how the different senses work together. New research from the laboratory of CSHL neuroscientist and Assistant Professor Adam Kepecs shows that when rats actively use the senses of smell (sniffing) and touch (through their whiskers) those two processes are locked in synchronicity. The team's paper, published today in the Journal of Neuroscience, shows that sniffing and "whisking" movements are synchronized even when they are running at different frequencies. Studies ...

Minimally invasive VATS-LCSD helps children with refractory ventricular arrhythmias

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: