Introduction
The intracardiac cardioverter-defibrillator (ICD) is shown to play an important role in preventing sudden cardiac death (SCD) in patients with structural heart disease (1). However, ICD shocksare associated with significant increase in morbidity and also have a negative impact on quality of life (2,3). Thus, every effort needs to be taken to reduce the incidence of ICD shocks without affecting their efficacy. The autonomic nervous system has a very important role in genesis and maintenance of cardiac arrhythmias, especially ventricular tachycardia VT (4,5). Cardiac sympathetic denervation (CSD) is thus, an interesting therapeutic option in many patients with VT when they are non-responsive to standard treatment. Though it’s role is established in managing hereditary channelopathies like long QT syndrome and catecholaminergic VT, an increasing volume of recent literature is consolidating its role as a viable therapeutic option in the management of refractory VT (6-10) in structural heart disease. The mechanism underlying the benefit of CSD in VT is by reducing the dispersion of myocardial repolarization and increasing the threshold of VT inducibility, as studied in animal models of myocardial infarction (11,12). There are only few studies assessing the long term efficacy of CSD in patients with refractory VT or VT storm (13,14). In the current article we aim to describe a relatively large single centre experience of long term effect of CSD in patients with refractory VT or VT storm.