Background: Ventricular arrhythmias are a leading cause of sudden death. The objective of this study was to characterise the results of patients with ventricular arrhythmias refractory to standard medical management, undergoing Video-assisted thoracoscopic cardiac sympathetic denervation (VAT-CSD) during 2012-2022 in Cali, Colombia., Methods: This was an observational retrospective study, using the Institutional General Thoracic Surgery Database for patient identification and retrospectively reviewing the clinical charts for data description and analysis., Results: Clinical records of 19 patients who underwent VAT-CSD for ventricular arrhythmia were analysed. The patients were predominantly male (73.7%) with an mean age of 62 years. Ischaemic heart disease was the main underlying condition (52.6%); all individuals had a diagnosis of heart failure, with comorbidities such as hypertension (63.1%), acute MI (57.8%) and diabetes (26.3%) also present. The procedure was performed bilaterally in 89.4% of cases and was successful with minimal perioperative complications. Postoperative follow-up showed improvement in symptoms, including a significant reduction in the number of ICD shocks and emergency department visits., Conclusion: VAT-CSD is a viable, safe and palliative therapeutic option for patients with ventricular arrhythmias who have not responded to conventional treatments, achieving a significant decrease in symptoms with low mortality and perioperative complications., Competing Interests: Disclosure: The authors have no conflicts of interest to declare. Funding: This study was funded by the Clinical Research Center at the Fundación Valle del Lili. Data availability: The de-identified data supporting the findings of this study are available upon request from the corresponding author. The data repository is Fundación Valle del Lili. Due to privacy or ethical restrictions, the data are not publicly available. We are dedicated to maintaining the confidentiality and safeguarding of participants' information. Authors' contributions: Conceptualisation: ÁISO, MVG; data curation: ÁISO; formal analysis: ÁISO, NFTE; funding acquisition: ÁISO, MVG; investigation: CÁO, JDGM, MACG, NFTE, LFPM, ÁISO, MVG; methodology: ÁISO; project administration: CÁO, JDGM; resources: CÁO, JDGM, MACG, NFTE, LFPM, ÁISO, MVG; software: ÁISO, NFTE; supervision: CÁO, JDGM; validation: ÁISO, MVG; visualisation: CÁO, JDGM, NFTE, ÁISO, MVG; writing – original draft preparation: CÁO, JDGM, MACG, NFTE, LFPM, ÁISO, MVG; writing – review & editing: CÁO, JDGM, NFTE, ÁISO, MVG. Ethics: This study was performed in line with the principles of the Declaration of Helsinki. Approved was granted by the Biomedical Research Ethics Committee of the Fundación Valle del Lili with protocol number 02003 on September 2022. Consent: This is an observational, anonymous and risk-free study. The Biomedical Research Ethics Committee of the Fundación Valle del Lili has confirmed that no informed written consent is required., (Copyright © The Author(s), 2024. Published by Radcliffe Group Ltd.)