TY - JOUR
T1 - Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias
T2 - Implications of Ultrasound-Guided Technique and Review of the Evidence
AU - Wittwer, Erica D.
AU - Radosevich, Misty A.
AU - Ritter, Matthew
AU - Cha, Yong Mei
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/8
Y1 - 2020/8
N2 - 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.
AB - 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.
KW - electrical storm
KW - stellate ganglion block
KW - ultrasound guidance
KW - ventricular arrhythmia
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U2 - 10.1053/j.jvca.2019.12.015
DO - 10.1053/j.jvca.2019.12.015
M3 - Review article
C2 - 31919004
AN - SCOPUS:85077619073
SN - 1053-0770
VL - 34
SP - 2245
EP - 2252
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 8
ER -