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Efficacy of early use of Percutaneous Stellate Ganglion Block for electrical storms

2024; Oxford University Press; Volume: 13; Issue: 11 Linguagem: Inglês

10.1093/ehjacc/zuae109

2048-8734

Enrico Baldi, Veronica Dusi, Roberto Rordorf, Alessia Currao, Sara Compagnoni, Antonio Sanzo, Francesca Romana Gentile, Simone Frea, Carol Gravinese, Filippo Angelini, Filippo Maria Cauti, Gianmarco Iannopollo, Francesco De Sensi, Edoardo Gandolfi, Laura Frigerio, Pasquale Crea, Domenico Zagari, Matteo Casula, G Binaghi, Giuseppe Sangiorgi, Lucy Barone, Simone Persampieri, Gabriele Dell’Era, Giuseppe Patti, Claudia Colombo, Giacomo Mugnai, Domenico Tavella, Francesco Notaristefano, Alberto Barengo, R Falcetti, Giulia Girardengo, Giuseppe D’Angelo, Nikita Tanese, Vito Sgromo, Gaetano Maria De Ferrari, Simone Savastano, Alessandro Fasolino, Silvia Miette Pontremoli, Sara Bendotti, Roberto Primi, Angelo Auricchio, Giulio Conte, Pietro Rossi, A Morena, António Toscano, Valeria Carinci, Giuseppe Dattilo, Nastasia Mancini, Massimo Tritto, Marco Corda, G Tola, E Cesarano, Claudia Scudu, Alessandro Lupi, Claudia Carassia, Federica De Vecchi, Sara Vargiu, Giovanni Battista Perego, Enrico Chieffo,

Cardiac Arrhythmias and Treatments

Abstract Aims Electrical storm (ES) is a life-threatening condition requiring a rapid management. Percutaneous stellate ganglion block (PSGB) is proved to be safe and effective on top of standard therapy, but no data are available about its early use. Methods and results We considered all patients enrolled from 1 July 2017 to 30 April 2024 in the STAR registry (STellate ganglion block for Arrhythmic stoRm), a multicentre, international, observational, prospective registry. We aimed to assess the effectiveness of the first PSGB only. Patients were divided into two groups depending on whether they received PSGB before [early PSGB, often due to antiarrhythmic drug (AAD) contraindication] or after (delayed PSGB) intravenous AADs (AADs other than beta-blockers). We considered 180 PSGB (26 early PSGB and 154 AAD first). In the early PSGB group, we observed a statistically significant reduction of treated arrhythmic events in the hour after PSGB compared with the hour before: 0 (0–0) vs. 4.5 (1–10), P < 0.001, and the extent of the reduction was similar in the early PSGB and delayed PSGB groups [−4.5 (−7 to −2) vs. −2.5 (−3.5 to −1.5), P = ns]. The percentage of patients free from arrhythmias was similar in the two groups up to 12 h after PSGB (81 vs. 84%, P = 0.6, after 1 h; 77 vs. 79%, P = 0.8, at 3 h; and 65 vs. 69%, P = 0.7, after 12 h). Conclusion Percutaneous stellate ganglion block is proved to be effective also when used early in the treatment of ES. Due to its rapidity of action, our results may suggest its early use to reduce the number of defibrillations and possibly to reduce the likelihood of a refractory ES.