Left cardiac sympathetic denervation for the prevention of life-threatening arrhythmias: the surgical supraclavicular approach to cervicothoracic sympathectomy

The progressive understanding of the diseases associated with significant risk for sudden cardiac death has fostered the development of early diagnosis and risk stratification. Thus, instead of starting from either a sudden death victim or a survivor of a cardiac arrest, it has become relatively common for cardiologists to identify individuals at high risk for sudden death, often after an arrhythmic nonlethal cardiac event such as syncope. Besides ischemic heart disease, it has also been recognized that children and young adults can be affected by arrhythmogenic disorders of genetic origin with a high propensity for lethal arrhythmias.