Experience treating electrical storm using an ultrasound guided stellate ganglion blockade

Introduction: Electrical storm is a life-threatening condition in an often medically complex patient population. Pharmacologic ultrasound-guided stellate ganglion blockade is a treatment option in combination with maximized systemic antiarrhythmic medications. There is an emerging body of case reports supporting stellate ganglion block efficacy and safety for this condition. Methods: Retrospective study on ultrasound-guided stellate ganglion blocks for electrical storm investigating patient clinical characteristics, immediate and long-term outcomes, and procedure related complications. Results: Four (75% men) critically ill patients maximized on standard antiarrhythmic therapy underwent six bedside ultrasound-guided stellate ganglion block procedures. All blocks were unilateral left-sided, two patients underwent repeat blocks for arrythmia reoccurrence. All patients experienced at least 12 hours free of ventricular arrhythmias with two thirds lasting beyond 24 hours. There were no observed complications. Conclusions: Ultrasound-guided stellate ganglion block is an effective and safe temporizing treatment option for electrical storm. Our institution-specific multidisciplinary guidelines were helpful in providing guidance for the use of stellate ganglion blocks in electrical storm.