Early ganglion stellate blockade as part of two-step treatment algorithm suppresses electrical storm and need for intubation
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F23%3A00131355" target="_blank" >RIV/00216224:14110/23:00131355 - isvavai.cz</a>
Result on the web
<a href="https://www.sciencedirect.com/science/article/pii/S1109966623000593?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/pii/S1109966623000593?via%3Dihub</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.hjc.2023.04.003" target="_blank" >10.1016/j.hjc.2023.04.003</a>
Alternative languages
Result language
angličtina
Original language name
Early ganglion stellate blockade as part of two-step treatment algorithm suppresses electrical storm and need for intubation
Original language description
Background: For the treatment of patients with electrical storm (ES), we established a two-step algorithm comprising standard anti-arrhythmic measures and early ultrasound-guided stellate ganglion blockade (SGB). In this single-center study, we evaluated the short-term efficacy of the algorithm and tested the hypothesis that early SGB might prevent the need for intubations.Methods: Overall, we analyzed data for 70 ES events in 59 patients requiring SGB (mean age 67.7 +/- 12.4 years, 80% males, left ventricular ejection fraction 30.0% +/- 9.1%), all with implantable cardioverter-defibrillators (ICDs).Results: The mean time from ES onset to SGB was 13.2 +/- 12.3 hours. Percentage and mean absolute reduction in shocks at 48 hours after SGB reached 86.8% (-6.3 shocks), and anti-tachycardiac pacing (ATP) declined by 65.9% (-51.1 ATPs; all P < 0.001). Patients with the highest sustained ventricular arrhythmia (VA) burden (shocks >= 10/48 h; ATPs 10-99/48 h and >= 100/48 h) experienced the highest percentage decrease in ICD therapy (shocks -99.1%; ATPs-92.1% and -10 0.0%, respectively). For clinical response by defined criteria and two outcome periods (1/no sustained VA <= 48 hours post SGB, and 2/no ICD shock or <3 ATPs/day from day 3 to discharge/catheter ablation/day 8), 75.7% and 76.1% experienced complete response, respectively. Catecholamine support, no/low-dose beta-blocker therapy, polymorphic/ mixed-type VA, and baseline sinus rhythm versus atrial fibrillation were more frequent in patients with early arrhythmia recurrence. Temporary Horner's syndrome occurred in 67.1%, and no other adverse events were recorded. Intubation and general anesthesia during and after SGB were not needed.Conclusion: The presented two-step algorithm for treating ES proved efficacious and safe. The results support implementation of early SGB in routine ES management.(c) 2023 Hellenic Society of Cardiology.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
HELLENIC JOURNAL OF CARDIOLOGY
ISSN
1109-9666
e-ISSN
2241-5955
Volume of the periodical
73
Issue of the periodical within the volume
September-October 2023
Country of publishing house
NL - THE KINGDOM OF THE NETHERLANDS
Number of pages
12
Pages from-to
24-35
UT code for WoS article
001083682800001
EID of the result in the Scopus database
2-s2.0-85162921108