Stellate ganglion block as a treatment for arrhythmic storm: an observational study

Introduction Arrhythmic storm is a life-threatening emergency with a high mortality rate. When acute conventional treatment is ineffective, a stellate ganglion block can contribute to the control of the arrhythmia by providing a visceral cervicothoracic sympathetic block. The objective of the study...

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Autores: López Millán, José Manuel, Coca Gamito, C., Cámara Faraig, A., Díaz Infante, Ernesto, García Rubira, Juan Carlos
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2024
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/167851
Acceso en línea:https://hdl.handle.net/11441/167851
Access Level:acceso abierto
Palabra clave:Electrical storm
Treatment
Stellate ganglion block
Ventricular tachycardia
id ES_e272bdd48ee6316cf499d4bbfe6b3a0c
oai_identifier_str oai:idus.us.es:11441/167851
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Stellate ganglion block as a treatment for arrhythmic storm: an observational study
Bloqueo del ganglio estrellado como tratamiento de la tormenta arrítmica: estudio observacional
title Stellate ganglion block as a treatment for arrhythmic storm: an observational study
spellingShingle Stellate ganglion block as a treatment for arrhythmic storm: an observational study
López Millán, José Manuel
Electrical storm
Treatment
Stellate ganglion block
Ventricular tachycardia
title_short Stellate ganglion block as a treatment for arrhythmic storm: an observational study
title_full Stellate ganglion block as a treatment for arrhythmic storm: an observational study
title_fullStr Stellate ganglion block as a treatment for arrhythmic storm: an observational study
title_full_unstemmed Stellate ganglion block as a treatment for arrhythmic storm: an observational study
title_sort Stellate ganglion block as a treatment for arrhythmic storm: an observational study
dc.creator.none.fl_str_mv López Millán, José Manuel
Coca Gamito, C.
Cámara Faraig, A.
Díaz Infante, Ernesto
García Rubira, Juan Carlos
author López Millán, José Manuel
author_facet López Millán, José Manuel
Coca Gamito, C.
Cámara Faraig, A.
Díaz Infante, Ernesto
García Rubira, Juan Carlos
author_role author
author2 Coca Gamito, C.
Cámara Faraig, A.
Díaz Infante, Ernesto
García Rubira, Juan Carlos
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Cirugía
CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
dc.subject.none.fl_str_mv Electrical storm
Treatment
Stellate ganglion block
Ventricular tachycardia
topic Electrical storm
Treatment
Stellate ganglion block
Ventricular tachycardia
description Introduction Arrhythmic storm is a life-threatening emergency with a high mortality rate. When acute conventional treatment is ineffective, a stellate ganglion block can contribute to the control of the arrhythmia by providing a visceral cervicothoracic sympathetic block. The objective of the study is to assess the effectiveness and safety of stellate ganglion blocks for the treatment of refractory arrhythmic storm. Method Follow-up of a cohort of patients with refractory arrhythmic storm that met the criteria for performing stellate ganglion blocks. The block was ultrasound-guided at C6-level using local anaesthetic and a steroid, left unilateral first, bilateral if no response, and followed by fluoroscopy-guided radiofrequency ablation at C7 if there was a favourable response but subsequent relapse. Results Seven patients were included, with a mortality rate during admission of 14.29%. Four patients received unilateral and three bilateral stellate ganglion blocks. Six were ablated and one of them had an implanted cardioverter-defibrillator. Arrhythmic storm was controlled temporarily beyond the effect of the local anaesthetic in all patients. Three underwent radiofrequency ablation and two underwent surgical thoracic sympathectomy. The only side effect was Horner's syndrome, which was observed in all cases after administering a stellate ganglion block with local anaesthetic. Two died after discharge and four are still at home, three of them without further admission due to ventricular events for more than two years. Conclusion An ultrasound-guided stellate ganglion block is an effective and safe technique in the treatment of refractory arrhythmic storm as a complement to the usual cardiological treatment.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/167851
url https://hdl.handle.net/11441/167851
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Revista española de anestesiología y reanimación, 71 (1), 1-7.
https://dialnet.unirioja.es/servlet/articulo?codigo=9244657
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Science Bv; Elsevier
publisher.none.fl_str_mv Elsevier Science Bv; Elsevier
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Stellate ganglion block as a treatment for arrhythmic storm: an observational studyBloqueo del ganglio estrellado como tratamiento de la tormenta arrítmica: estudio observacionalLópez Millán, José ManuelCoca Gamito, C.Cámara Faraig, A.Díaz Infante, ErnestoGarcía Rubira, Juan CarlosElectrical stormTreatmentStellate ganglion blockVentricular tachycardiaIntroduction Arrhythmic storm is a life-threatening emergency with a high mortality rate. When acute conventional treatment is ineffective, a stellate ganglion block can contribute to the control of the arrhythmia by providing a visceral cervicothoracic sympathetic block. The objective of the study is to assess the effectiveness and safety of stellate ganglion blocks for the treatment of refractory arrhythmic storm. Method Follow-up of a cohort of patients with refractory arrhythmic storm that met the criteria for performing stellate ganglion blocks. The block was ultrasound-guided at C6-level using local anaesthetic and a steroid, left unilateral first, bilateral if no response, and followed by fluoroscopy-guided radiofrequency ablation at C7 if there was a favourable response but subsequent relapse. Results Seven patients were included, with a mortality rate during admission of 14.29%. Four patients received unilateral and three bilateral stellate ganglion blocks. Six were ablated and one of them had an implanted cardioverter-defibrillator. Arrhythmic storm was controlled temporarily beyond the effect of the local anaesthetic in all patients. Three underwent radiofrequency ablation and two underwent surgical thoracic sympathectomy. The only side effect was Horner's syndrome, which was observed in all cases after administering a stellate ganglion block with local anaesthetic. Two died after discharge and four are still at home, three of them without further admission due to ventricular events for more than two years. Conclusion An ultrasound-guided stellate ganglion block is an effective and safe technique in the treatment of refractory arrhythmic storm as a complement to the usual cardiological treatment.Introducción La tormenta arrítmica (TA) es una situación de emergencia potencialmente letal, con una elevada tasa de mortalidad. Cuando el tratamiento convencional agudo es inefectivo, el bloqueo del ganglio estrellado puede ayudar a controlar la arritmia, aportando un bloqueo simpático cervicotorácico visceral. El objetivo de este estudio es valorar la efectividad y seguridad de los bloqueos del ganglio estrellado (BGE) para el tratamiento de la TA refractaria. Método Seguimiento de una cohorte de pacientes con TA refractaria que cumplieron los criterios para la realización de BGE. Dicho bloqueo fue ecoguiado al nivel de C6, utilizando un anestésico y un esteroide, de manera unilateral izquierda en primer lugar, y bilateral de no existir respuesta, realizándose posteriormente ablación mediante radiofrecuencia (RFC) guiada por fluoroscopio en C7 de no existir respuesta favorable, sino recidiva subsiguiente. Resultados Se incluyeron siete pacientes, con una tasa de mortalidad durante el ingreso de 14,29%. Cuatro pacientes recibieron bloqueos unilaterales del ganglio estrellado, y en tres pacientes se realizaron bloqueos bilaterales. En seis de ellos se aplicó ablación, y uno de ellos tenía implantado un cardioversor-desfibrilador. La TA fue controlada temporalmente, más allá del efecto del anestésico local en todos los pacientes. Tres de ellos recibieron ablación por RFC, y dos simpatectomías torácicas quirúrgicas. El único efecto secundario fue el síndrome de Horner, que se observó en todos los casos tras realizar el bloqueo del ganglio estrellado con anestésico local. Dos pacientes murieron tras recibir el alta, y cuatro siguen en sus casas, tres de ellos sin haber sido ingresados a causa de episodios ventriculares durante más de dos años. Conclusión El bloqueo ecoguiado del ganglio estrellado es una técnica efectiva y segura para el tratamiento de la TA refractaria, como complemento del tratamiento cardiológico habitual.Elsevier Science Bv; ElsevierCirugíaCTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/167851reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésRevista española de anestesiología y reanimación, 71 (1), 1-7.https://dialnet.unirioja.es/servlet/articulo?codigo=9244657info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1678512026-06-17T12:51:07Z
score 15,812455

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