Background Electrical storm can be challenging to treat, requiring a multidisciplinary team to coordinate medical management and invasive procedures. As the stellate ganglion provides efferent sympathetic outflow to the myocardium, stellate ganglion blocks (SGB) can be used to combat ventricular arrhythmias that arise from sympathetic overactivity. Data are scarce regarding SGB catheters as a treatment for electrical storm. We reviewed our use of SGB catheters for refractory electrical storm using our pathway collaboratively developed by critical care, cardiology, and regional anesthesia teams.
Methods We conducted a retrospective cohort study of patients who underwent an SGB for electrical storm between January 2020 and April 2022 in our cardiovascular intensive care unit. The primary outcome was the sustained cessation of electrical storm for 24 hours.
Results Upon chart review, 27 patients were identified and 11 met inclusion criteria. Cessation of electrical storm for 24 hours was achieved in 90% (n=10) of patients after left SGB. Similarly, 90% (n=10) had no documented episodes of ventricular arrhythmias requiring intervention within 6 hours after SGB.
Conclusions SGBs can interrupt or treat electrical storm. SGB catheters allow for prolonged arrhythmia cessation without repeated blocks and decrease the risk of repeat episodes of ventricular arrhythmias.
- Autonomic Nerve Block
- Critical Care
- Outcome Assessment, Health Care
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Contributors RAP was involved in study conception, study design, data collection, data analysis, interpretation of results, and manuscript draft and preparation. JMC and RMG were involved in study conception, study design, and manuscript draft and preparation. BJW was involved in study design, data analysis, interpretation of results, and manuscript draft and preparation. SHW was involved in study conception, study design, data analysis, interpretation of results, and manuscript draft and preparation. All authors reviewed the results and approved the final version of the manuscript.
Funding This work received internal support (Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina); however, no funding was used.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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