Chronic refractory angina pectoris treated by bilateral stereotactic radiosurgical stellate ganglion ablation: first-in-man case report

Hudec, M; Jiravský, Otakar; Spacek, Radim; Neuwirth, Radek; Knybel, Lukáš; Škňouřil, Libor; Cvek, Jakub; Miklik, Roman

doi:10.1093/ehjcr/ytab184

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Additionally, currently, existing stellate ganglion radiofrequency ablation techniques and stereotactic radiosurgery are performed by anesthesiologists for patients with acute digital ischemia, a complex regional pain syndrome, or refractory chest pain [ 109 , 110 , 111 ]. These techniques, however, have not been used to manage VAs.…”

Section: Future Directionsmentioning

confidence: 99%

Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go

Chung

Lin

et al. 2023

JPM

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The nuance of autonomic cardiac control has been studied for more than 400 years, yet little is understood. This review aimed to provide a comprehensive overview of the current understanding, clinical implications, and ongoing studies of cardiac sympathetic modulation and its anti-ventricular arrhythmias’ therapeutic potential. Molecular-level studies and clinical studies were reviewed to elucidate the gaps in knowledge and the possible future directions for these strategies to be translated into the clinical setting. Imbalanced sympathoexcitation and parasympathetic withdrawal destabilize cardiac electrophysiology and confer the development of ventricular arrhythmias. Therefore, the current strategy for rebalancing the autonomic system includes attenuating sympathoexcitation and increasing vagal tone. Multilevel targets of the cardiac neuraxis exist, and some have emerged as promising antiarrhythmic strategies. These interventions include pharmacological blockade, permanent cardiac sympathetic denervation, temporal cardiac sympathetic denervation, etc. The gold standard approach, however, has not been known. Although neuromodulatory strategies have been shown to be highly effective in several acute animal studies with very promising results, the individual and interspecies variation between human autonomic systems limits the progress in this young field. There is, however, still much room to refine the current neuromodulation therapy to meet the unmet need for life-threatening ventricular arrhythmias.

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Section: Future Directionsmentioning

confidence: 99%

Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go

Chung

Lin

et al. 2023

JPM

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“…Recently, stereotactic radiosurgical stellate ganglion ablation following a successful diagnostic SGB was reported to provide pain relief at one-year follow-up in a patient with refractory angina. [ 20 ]…”

Section: Reviewmentioning

confidence: 99%

Stellate ganglion block beyond chronic pain: A literature review on its application in painful and non-painful conditions

Singh

Rajarathinam

2023

Journal of Anaesthesiology Clinical Pharmacology

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Cervical sympathetic or stellate ganglion blocks (SGBs) have been commonly used in the treatment of painful conditions like complex regional pain syndrome (CRPS). However, there is literature to suggest its utility in managing non-painful conditions as well. The focus of this literature review is to provide an overview of indications for SGB for painful and non-painful conditions. We identified published journal articles in the past 25 years from Embase and PubMed databases with the keywords “cervical sympathetic block, stellate ganglion blocks, cervical sympathetic chain, and cervical sympathetic trunk”. A total of 1556 articles were obtained from a literature search among which 311 articles were reviewed. Among painful conditions, there is a lack of evidence in favor of or against the use of SGB for CRPS despite its common use. SGB can provide postoperative analgesia in selective surgeries and can be effective in temporary pain control of refractory angina and the acute phase of herpes zoster infection. Among non-painful conditions, SGB may have beneficial effects on the management of post-traumatic stress disorder (PTSD), refractory ventricular arrhythmias, hot flashes in postmenopausal women, and breast cancer–related lymphedema. Additionally, there have been various case reports illustrating the benefits of SGB in the management of cerebral vasospasm, upper limb erythromelalgia, thalamic and central post-stroke pain, palmar hyperhidrosis, orofacial pain, etc. In our review of literature, we found that SGB can be useful in the management of various non-painful conditions beyond the well-known treatment for CRPS, although further studies are required to prove its efficacy.

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2021

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Chronic refractory angina pectoris treated by bilateral stereotactic radiosurgical stellate ganglion ablation: first-in-man case report

Cited by 4 publications

References 25 publications

Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go

Sympathetic Modulation in Cardiac Arrhythmias: Where We Stand and Where We Go

Stellate ganglion block beyond chronic pain: A literature review on its application in painful and non-painful conditions

Multiple drugs

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