Early ganglion stellate blockade as part of two-step treatment algorithm suppresses electrical storm and need for intubation

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Early ganglion stellate blockade as part of two-step treatment algorithm suppresses electrical storm and need for intubation

Popis výsledku v původním jazyce

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 &lt; 0.001). Patients with the highest sustained ventricular arrhythmia (VA) burden (shocks &gt;= 10/48 h; ATPs 10-99/48 h and &gt;= 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 &lt;= 48 hours post SGB, and 2/no ICD shock or &lt;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.

Název v anglickém jazyce

Early ganglion stellate blockade as part of two-step treatment algorithm suppresses electrical storm and need for intubation

Popis výsledku anglicky

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 &lt; 0.001). Patients with the highest sustained ventricular arrhythmia (VA) burden (shocks &gt;= 10/48 h; ATPs 10-99/48 h and &gt;= 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 &lt;= 48 hours post SGB, and 2/no ICD shock or &lt;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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2023

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

HELLENIC JOURNAL OF CARDIOLOGY

ISSN

1109-9666

e-ISSN

2241-5955

Svazek periodika

73

Číslo periodika v rámci svazku

September-October 2023

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

12

Strana od-do

24-35

Kód UT WoS článku

001083682800001

EID výsledku v databázi Scopus

2-s2.0-85162921108