Refractory Ventricular Tachycardia in a Patient With a Left Ventricular Assist Device Successfully Treated With Stellate Ganglion Phototherapy

Sato, Tomoya; Kamada, Rui; Koizumi, Toru; Takenaka, Sakae; Tada, Atsushi; Tsujinaga, Shingo; Konishi, Takao; Sato, Takuma; Watanabe, Masaya; Nagai, Toshiyuki; Anzai, Toshihisa

doi:10.1016/j.cjca.2020.08.002

Cited by 3 publications

(5 citation statements)

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“…In contrast, our approach involved irradiating solely the left side of the patient’s neck for 5 min daily with the SGP. Sato et al 15 demonstrated that continuous irradiation of only one side of the patient’s neck for 5 min with SGP may serve as an adjunctive therapy or bridge therapy for refractory VAs. Therefore, we also adopted a 5 min SGP therapy.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of stellate ganglion phototherapy on ventricular tachycardia storm requiring mechanical circulatory support devices: a case report

Takahashi,

Egami,

Nishino

et al. 2024

European Heart Journal - Case Reports

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Background Ventricular arrhythmias are a significant cause of morbidity and mortality in patients with ischaemic heart disease. When pharmacologic therapies, catheter ablation (CA), and implantable cardioverter defibrillator (ICD) are ineffective, stellate ganglion blockade (SGB), sympathectomy, and renal sympathetic denervation are considered. However, they are invasive for patients with high bleeding risk. We present a case of successfully recovering from haemodynamically unstable ventricular tachycardia (VT) storm with stellate ganglion phototherapy (SGP) in a non-invasive manner. Case summary A 73-year-old male presented to the emergency department with chief complaint of general malaise, resulting from VT storm associated with ischaemic cardiomyopathy. He had a history of CA and implantation of ICD. Despite multiple electrical cardioversions, pharmacologic therapies, and deep sedation with mechanical circulatory support (MCS), VT storm was not controlled. Thereafter, we irradiated the patient’s neck with SGP to inhibit sympathetic neurological activity, which suppressed VT storm and dramatically improved his haemodynamic status. Discussion It has been reported that SGP is an alternative to SGB for refractory VT storm. Stellate ganglion phototherapy was easy and non-invasive to perform because we just irradiated the patient’s neck with the near-infrared light for 5 min per day. If conventional therapies are ineffective in suppressing VT storm, SGP may be considered as a next step, especially for patients with high bleeding risk. However, since the effect of a single SGP lasts only 1–2 days, it should be performed as a bridge therapy to CA or sympathectomy. Stellate ganglion phototherapy may be effective in suppressing VT storm that requires MCS devices.

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Section: Discussionmentioning

confidence: 99%

Clinical impact of stellate ganglion phototherapy on ventricular tachycardia storm requiring mechanical circulatory support devices: a case report

Takahashi,

Egami,

Nishino

et al. 2024

European Heart Journal - Case Reports

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“…Ventricular arrhythmogenesis is often associated with the sympathetic nervous system 7. SGP, a neuromodulation therapy that non-invasively suppresses sympathetic neurological activity, is reported to be effective for RVT 11 12. The stellate ganglion, which is the therapeutic target of neuromodulation therapies, is located in the intervertebral space between the C7 and T1 vertebral bodies 18.…”

Section: Discussionmentioning

confidence: 99%

“…The wavelength band is 600–1600 nm, which allows the non-invasive penetration of light into the tissues to inhibit sympathetic neurological activity without any other nerve blockades 11. Although SGP has been shown to have an antiarrhythmic effect on RVT in dilated cardiomyopathy or ischaemic cardiomyopathy,11 12 limited data are available regarding patients with CS.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, neuromodulation therapies via the stellate ganglion, such as surgical stellate ganglion denervation, stellate ganglion block with local anaesthetics and stellate ganglion block with thoracic epidural anaesthesia, have been used to manage refractory ventricular tachycardias (RVTs) 8–10. In addition, the efficacy of stellate ganglion phototherapy (SGP) in suppressing RVTs was recently reported 11 12. SGP is a non-invasive procedure for modification of the sympathetic nervous system, which can be applied in patients with a high risk of bleeding or severe conditions 11 12.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the efficacy of stellate ganglion phototherapy (SGP) in suppressing RVTs was recently reported 11 12. SGP is a non-invasive procedure for modification of the sympathetic nervous system, which can be applied in patients with a high risk of bleeding or severe conditions 11 12. However, data on the efficacy of SGP for RVT in patients with CS are limited.…”

Section: Introductionmentioning

confidence: 99%

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Successful use of stellate ganglion phototherapy in refractory ventricular tachycardia in a patient with cardiac sarcoidosis

et al. 2022

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Ventricular arrhythmias are a life-threatening factor in cardiac sarcoidosis (CS), posing a significant therapeutic challenge. Stellate ganglion phototherapy (SGP), a non-invasive procedure for modification of the sympathetic nervous system, is an effective treatment for refractory ventricular tachycardia (RVT). However, there are limited data on the efficacy of SGP for RVT in patients with CS. In our case report, we found that SGP was effective for treating RVT in a patient with CS.We present the case of a man in his 60s with multiple cardioversions of implantable cardioverter defibrillator for ventricular tachycardia. The patient was administered prednisolone for the management of CS, which subsequently led to an increase in anti-tachycardia pacing for ventricular tachycardias. We introduced SGP to suppress RVT and anti-tachycardia pacing decreased from 371 to 25 events. Thus, SGP could be a feasible option for the management of RVT in patients with CS.

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Refractory Ventricular Tachycardia in a Patient With a Left Ventricular Assist Device Successfully Treated With Stellate Ganglion Phototherapy

Cited by 3 publications

References 4 publications

Clinical impact of stellate ganglion phototherapy on ventricular tachycardia storm requiring mechanical circulatory support devices: a case report

Clinical impact of stellate ganglion phototherapy on ventricular tachycardia storm requiring mechanical circulatory support devices: a case report

Successful use of stellate ganglion phototherapy in refractory ventricular tachycardia in a patient with cardiac sarcoidosis

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