Stellate ganglion blockade and bilateral cardiac sympathetic denervation in patients with life-threatening ventricular arrhythmias

J Cardiovasc Electrophysiol. 2017 Aug;28(8):903-908. doi: 10.1111/jce.13249.

Abstract

Autonomic modulation is being increasingly employed as a strategy to treat ventricular arrhythmias refractory to beta-blockers, antiarrhythmic drugs, and catheter-based ablation procedures. We report 6 patients with refractory ventricular tachycardia (VT) or ventricular fibrillation (VF) treated with stellate ganglion blockade (SGB) and/or bilateral cardiac sympathetic denervation (CSD). Our case series emphasizes the concept that the cardiac sympathetic nerves are important targets in the management of ventricular arrhythmias. SGB and CSD can be effective in suppressing VT/VF and can be offered to patients with refractory ventricular arrhythmias as an adjunct to conventional therapy.

Keywords: autonomic modulation; cardiac sympathetic denervation; electrical storm; stellate ganglion block; ventricular arrhythmias.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Autonomic Nerve Block / methods*
  • Catheter Ablation / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Stellate Ganglion* / diagnostic imaging
  • Stellate Ganglion* / physiopathology
  • Sympathectomy / methods*
  • Tachycardia, Ventricular / diagnostic imaging
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / therapy*
  • Ultrasonography, Interventional / methods
  • Ventricular Fibrillation / diagnostic imaging
  • Ventricular Fibrillation / physiopathology
  • Ventricular Fibrillation / therapy*