Why the study?
Management of refractory ventricular tachycardia in patients with electrical storm and nonischemic cardiomyopathy remains challenging despite catheter ablation and pharmacotherapy.
Observational (n=83)
Yes
Absolute Event Rate: 0% vs 6%
p-value: p=<0.0001
May reduce VT burden in refractory electrical storm as bridge therapy; hypothesis-generating, requiring prospective trials.
A 64-year-old man with a history of nonischemic cardiomyopathy (NICM) presented with electrical storm (ES). Episodes of ventricular tachycardia (VT) persisted despite endocardial catheter ablations and exhaustive pharmacotherapy. We used alternating regional anesthesia techniques, left stellate ganglion block, and proximal intercostal block to reduce sympathetic input to the heart, resulting in a significant decrease in VT burden. By using alternating catheter locations, we were able to maintain continuous sympathetic blockade for 31 days and bridge the patient to a successful orthotopic heart transplant.
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Bains et al. (2021) conducted an observational in Refractory ventricular arrhythmias and electrical storm (n=83). Continuous percutaneous stellate ganglion block (C-PSGB) vs. Baseline (pre-intervention) was evaluated on Median number of VAs treated with ATP or shocks in the 12 hours after the procedure (p=<0.0001).
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