Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias: Implications of Ultrasound-Guided Technique and Review of the Evidence

Erica D. Wittwer, Misty A. Radosevich, Matthew Ritter, Yong Mei Cha

Research output: Contribution to journalReview articlepeer-review

Abstract

Refractory ventricular arrhythmias (VAs) carry high mortality rates despite electrical and pharmacologic therapy utilization. These patients often require aggressive hemodynamic support, including mechanical circulatory devices such as extracorporeal membrane oxygenation because of progressive hemodynamic and metabolic deterioration. Sympathetic nervous system stimulation and neuronal remodeling after myocardial insults have been implicated as drivers of refractory VAs. This understanding has led to interest in and a growing body of experience with percutaneous blockade of the stellate ganglion as a means of interrupting the vicious cycle of refractory VAs. A number of techniques have been described for stellate ganglion blockade, including landmark-driven approaches, fluoroscopy-assisted blockade, and ultrasound guidance. Herein, the literature is evaluated and the authors’ experience with stellate ganglion blockade using ultrasound guidance for refractory VAs is described.

Original languageEnglish (US)
Pages (from-to)2245-2252
Number of pages8
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume34
Issue number8
DOIs
StatePublished - Aug 2020

Keywords

  • electrical storm
  • stellate ganglion block
  • ultrasound guidance
  • ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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