Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims The term ventricular storm (VS) is defined as the occurrence of 2 or more separate episodes of ventricular tachycardia or fibrillation (VT/VF) or 3 or more appropriate discharges of an implantable cardioverter defibrillator (ICD) for VT/VF in a 24-hour period. We combined stellate ganglion blockade with epidural thoracic anesthesia to achieve rhythm control in a patient with a history of multiple episodes of VS that were not controlled with intravenous antiarrhythmic medication.

Results A patient in the early 40s was seen in the emergency department of our hospital with complaints of multiple discharges of his ICD. The patient was admitted to the cardiac intensive care unit and presented multiple episodes of VT. This led to the need for deep sedation with orotracheal intubation and mechanical ventilation. Intravenous lidocaine treatment was started but the patient had a recurrence of the episodes of VT. We decided to combine stellate ganglion block with epidural thoracic anesthesia. After the sympathetic block, there was no recurrence of the arrhythmic episodes. The patient was then transferred for ablation treatment.

Conclusions We demonstrated the efficacy of both techniques in managing a patient with multiple episodes of ventricular storm. Sympathetic block and rhythm control were successfully achieved before transfer to another facility for definitive treatment.