Effective Use of Percutaneous Stellate Ganglion Blockade in Patients With Electrical Storm
- PMID: 31514529
- DOI: 10.1161/CIRCEP.118.007118
Effective Use of Percutaneous Stellate Ganglion Blockade in Patients With Electrical Storm
Abstract
Background: Percutaneous stellate ganglion blockade (SGB) has been used for drug-refractory electrical storm due to ventricular arrhythmia (VA); however, the effects and long-term outcomes have not been well studied.
Methods: This study included 30 consecutive patients who had drug-refractory electrical storm and underwent percutaneous SGB between October 1, 2013, and March 31, 2018. Bupivacaine, alone or combined with lidocaine, was injected into the neck with good local anesthetic spread in the vicinity of the left stellate ganglion (n=15) or both stellate ganglia (n=15). Data were collected for patient clinical characteristics, immediate and long-term outcomes, and procedure-related complications.
Results: Clinical characteristics included age, 58±14 years; men, 73.3%; and left ventricular ejection fraction, 34±16%. At 24 hours, 60% of patients were free of VA. Patients whose VA was controlled had a lower hospital mortality rate than patients whose VA continued (5.6% versus 50.0%; P=0.009). Implantable cardioverter-defibrillator interrogation showed a significant 92% reduction in VA episodes from 26±41 to 2±4 in the 72 hours after SGB (P<0.001). Patients who died during the same hospitalization (n=7) were more likely to have ischemic cardiomyopathy (100% versus 43.5%; P=0.03) and recurrent VA within 24 hours (85.7% versus 26.1%; P=0.009). There were no procedure-related major complications.
Conclusions: SGB effectively attenuated electrical storm in more than half of patients without procedure-related complications. Percutaneous SGB may be considered for stabilizing ventricular rhythm in patients for whom other therapies have failed.
Keywords: hospital mortality; hospitalization; stellate ganglion block; sympathetic nervous system; ventricular arrhythmia.
Comment in
-
Stellate Block in Refractory Ventricular Tachycardia: The Calm After the Storm.Circ Arrhythm Electrophysiol. 2019 Sep;12(9):e007707. doi: 10.1161/CIRCEP.119.007707. Epub 2019 Sep 13. Circ Arrhythm Electrophysiol. 2019. PMID: 31514530 No abstract available.
Similar articles
-
[Repeated stellate ganglion blockade for the treatment of ventricular tachycardia storm in patients with nonischemic cardiomyopathy: a new therapeutic option for patients with malignant arrhythmias].Zhonghua Xin Xue Guan Bing Za Zhi. 2023 May 24;51(5):521-525. doi: 10.3760/cma.j.cn112148-20220525-00411. Zhonghua Xin Xue Guan Bing Za Zhi. 2023. PMID: 37198124 Chinese.
-
Stellate ganglion block catheters for refractory electrical storm: a retrospective cohort and care pathway.Reg Anesth Pain Med. 2023 May;48(5):224-228. doi: 10.1136/rapm-2022-104172. Epub 2023 Feb 1. Reg Anesth Pain Med. 2023. PMID: 36725213 Free PMC article. Review.
-
Stellate Ganglion Blockade With Continuous Infusion Versus Single Injection for Treatment of Ventricular Arrhythmia Storm.JACC Clin Electrophysiol. 2021 Apr;7(4):452-460. doi: 10.1016/j.jacep.2020.09.032. Epub 2020 Dec 24. JACC Clin Electrophysiol. 2021. PMID: 33358672
-
Efficacy of Stellate Ganglion Blockade in Managing Electrical Storm: A Systematic Review.JACC Clin Electrophysiol. 2017 Sep;3(9):942-949. doi: 10.1016/j.jacep.2017.06.006. JACC Clin Electrophysiol. 2017. PMID: 29270467 Free PMC article.
-
Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: A systematic review and meta-analysis.J Cardiovasc Electrophysiol. 2017 Dec;28(12):1460-1467. doi: 10.1111/jce.13324. Epub 2017 Sep 1. J Cardiovasc Electrophysiol. 2017. PMID: 28833780 Review.
Cited by
-
Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia.Europace. 2024 Mar 30;26(4):euae074. doi: 10.1093/europace/euae074. Europace. 2024. PMID: 38531027 Free PMC article.
-
A modified approach to percutaneous ultrasound-guided left stellate ganglion block for drug-refractory electrical storm: a case report.Eur Heart J Case Rep. 2024 Feb 20;8(3):ytae101. doi: 10.1093/ehjcr/ytae101. eCollection 2024 Mar. Eur Heart J Case Rep. 2024. PMID: 38476286 Free PMC article.
-
Stellate ganglion blockade for the management of ventricular arrhythmia storm.Eur Heart J. 2024 Mar 7;45(10):834-836. doi: 10.1093/eurheartj/ehae083. Eur Heart J. 2024. PMID: 38366239 No abstract available.
-
Electrical storm treatment by percutaneous stellate ganglion block: the STAR study.Eur Heart J. 2024 Mar 7;45(10):823-833. doi: 10.1093/eurheartj/ehae021. Eur Heart J. 2024. PMID: 38289867 Free PMC article.
-
Case report: high-dose carvedilol as a potential key drug for arrhythmias in histiocytoid cardiomyopathy.Eur Heart J Case Rep. 2023 Nov 27;7(12):ytad588. doi: 10.1093/ehjcr/ytad588. eCollection 2023 Dec. Eur Heart J Case Rep. 2023. PMID: 38089118 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources