Stellate Ganglion Blockade: an Intervention for the Management of Ventricular Arrhythmias

• Type of Material: Article
• Authors: Arun Ganesh, Duke University; Muhammad Qadri, Emory University; Richard L. Boortz-Marx, Duke University; Sana M. Al-Khatib, Duke University; David H. Harpole Jr, Duke University; Jason N. Katz, Duke University; Jason I. Koontz, Duke University; Joseph P. Mathew, Duke University; Neil D. Ray, Duke University; Albert Y. Sun, Duke University; Betty C. Tong, Duke University; Luis Ulloa, Duke University; Jonathan P. Piccini, Duke University; Marat Fudim, Duke University
• Language: English
• Date: 2020-10-23
• Publisher: Springer (part of Springer Nature)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020, Springer Science Business Media, LLC, part of Springer Nature
• Final Published Version (URL): http://dx.doi.org/10.1007/s11906-020-01111-8
• Title of Journal or Parent Work: CURRENT HYPERTENSION REPORTS
• Volume: 22
• Issue: 12
• Keywords: Ventricular arrhythmia; Ventricular tachycardia; Stellate ganglion block; Ventricular fibrillation
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, General; Biology, Genetics

Abstract

Purpose of Review To highlight the indications, procedural considerations, and data supporting the use of stellate ganglion blockade (SGB) for management of refractory ventricular arrhythmias. Recent Findings In patients with refractory ventricular arrhythmias, unilateral or bilateral SGB can reduce arrhythmia burden and defibrillation events for 24–72 h, allowing time for use of other therapies like catheter ablation, surgical sympathectomy, or heart transplantation. The efficacy of SGB appears to be consistent despite the type (monomorphic vs polymorphic) or etiology (ischemic vs non-ischemic cardiomyopathy) of the ventricular arrhythmia. Ultrasound-guided SGB is safe with low risk for complications, even when performed on anticoagulation. Summary SGB is effective and safe and could be considered for patients with refractory ventricular arrhythmias.