Left Stellate Ganglion Blockade for the Management of Drug-Resistant Electrical Storm

Patel, Rishin A.; Priore, Debra L.; Szeto, Wilson Y.; Slevin, Kieran A.

doi:10.1111/j.1526-4637.2011.01167.x

Cited by 35 publications

(14 citation statements)

References 10 publications

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“…LSG block is a percutaneous approach to block the peripheral sympathetic ganglia using local anaesthetics. The technique reduces sympathetically driven cardiac excitability in animal and human studies (Nademanee et al 2000;Loyalka et al 2011;Patel et al 2011). Nademanee and colleagues reported that cardiac sympathetic blockade, including LSG block, is superior to the Advanced Cardiovascular Life Support recommended antiarrhythmic therapy in treating patients with electrical storm (Nademanee et al 2000).…”

Section: Mechanism Of Benefit Of Csdmentioning

confidence: 99%

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Clinical neurocardiology defining the value of neuroscience‐based cardiovascular therapeutics

Shivkumar¹,

Ajijola²,

Anand

et al. 2016

The Journal of Physiology

248

212

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The autonomic nervous system regulates all aspects of normal cardiac function, and is recognized to play a critical role in the pathophysiology of many cardiovascular diseases. As such, the value of neuroscience-based cardiovascular therapeutics is increasingly evident. This White Paper reviews the current state of understanding of human cardiac neuroanatomy, neurophysiology, pathophysiology in specific disease conditions, autonomic testing, risk stratification, and neuromodulatory strategies to mitigate the progression of cardiovascular diseases.

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Section: Mechanism Of Benefit Of Csdmentioning

confidence: 99%

“…; Patel et al . ). Nademanee and colleagues reported that cardiac sympathetic blockade, including LSG block, is superior to the Advanced Cardiovascular Life Support recommended antiarrhythmic therapy in treating patients with electrical storm (Nademanee et al .…”

Section: Introductionmentioning

confidence: 97%

Clinical neurocardiology defining the value of neuroscience‐based cardiovascular therapeutics

Shivkumar¹,

Ajijola²,

Anand

et al. 2016

The Journal of Physiology

248

212

View full text Add to dashboard Cite

show abstract

“…Nademanee et al .,[3] reported that cardiac sympathetic blockade is superior to the antiarrhythmic therapy in treating ES and have advocated LSGB for reducing the sympathetic surge. There are a few publications on efficacy of the LSGB[67]and thoracic epidural anaesthesia (TEA)[89]in lowering the incidents of ventricular arrhythmias during ES. These therapeutic approaches reduce adrenergic tone that is most likely responsible for the reported efficacy.…”

Section: Discussionmentioning

confidence: 99%

Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation

Gadhinglajkar¹,

Sreedhar²,

Unnikrishnan³

et al. 2013

Indian J Anaesth

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An electrical storm is usually associated with catecholaminergic surge following myocardial ischaemia and manifest as recurrent ventricular arrhythmias, requiring frequent DC shocks. Delivering repeated DC shocks induces myocardial damage and further worsens the arrhythmias, which are resistant to the antiarrhythmic drugs. Cardiac sympathetic blockade abates the excessive catecholaminergic drive and help pacifying the malignant ventricular arrhythmias. We treated the electrical storm in a 52-year-old male with ultrasound-guided left sympathetic ganglion block followed by surgical left cardiac sympathetic denervation. The patient remained symptom-free without any incident of ventricular arrhythmias for 8 months after the surgery. The ultrasonography during blockade of the stellate ganglion enhances the success rate of the technique, reduces the quantity of local anaesthetic required to produce desired effects and prevents technical complications. Supraclavicular surgical access to the upper thoracic sympathetic chain obviates the necessity for one lung ventilation and lateral decubitus during surgery, when the patient is in hemodynamically unstable condition. Sympathectomy can be performed under general anaesthesia taking cautions to avoid sympathetic stimulation in intraoperative period.

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“…A change in temperature and sweating pattern of the left upper limb may be a better indicator than development of Horner's syndrome in this regard. Nevertheless, percutaneous stellate ganglion block has been reported to be temporarily effective, in controlling ES in multiple reports [9,10]. This is a promising approach, as it can be performed with relative ease even in unstable patients and thus can help in tiding over the crisis.…”

Section: Pharmacological Lscdmentioning

confidence: 95%

Left sympathetic cardiac denervation in managing electrical storm: acute outcome and long term follow up

Prabhu

Abhilash

et al. 2016

J Interv Card Electrophysiol

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Left Stellate Ganglion Blockade for the Management of Drug-Resistant Electrical Storm

Abstract: The patient was rapidly stabilized following left stellate ganglion blockade.

Cited by 35 publications

References 10 publications

Clinical neurocardiology defining the value of neuroscience‐based cardiovascular therapeutics

Clinical neurocardiology defining the value of neuroscience‐based cardiovascular therapeutics

Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation

Left sympathetic cardiac denervation in managing electrical storm: acute outcome and long term follow up

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