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The long QT interval syndrome. A Rosetta stone for sympathetic related ventricular tachyarrhythmias.

In a recent issue of Circulation, Schwartz et all provided further evidence of this sympathetic link by demonstrating the beneficial effects of left-sided cardiac sympathetic denervation in 85 patients, 84 of whom (91%) continued to have syncope or cardiac arrest before denervation despite receiving ,3-adrenoceptor blockade. After surgery, the number of patients with cardiac events, the number of cardiac events per patient, and the number of patients with five or more cardiac events all decreased significantly. However, there still were seven (8%) sudden deaths, reducing the 5-year survival to 94%.