Left stellate ganglion block, a rescue treatment for ventricular arrhythmia refractory to radiofrequency catheter ablation: A care-compliant case report

Medicine (Baltimore). 2019 Nov;98(44):e17790. doi: 10.1097/MD.0000000000017790.

Abstract

Rationale: Stellate Ganglion Block (SGB) provides a blockade of sympathetic signals from the sympathetic chain and appears to be a promising method of controlling refractory ventricular arrhythmias, but there are scanty data in the literature.

Patient concerns: Herein, we describe a 59-year-old male patient with a history of non-ischemic cardiomyopathy and suffering from frequent VT episodes, who received ICD implantation and regular amiodarone medication control.

Diagnoses: Monomorphic VT refractory to standard medication control and focal extensive catheter ablation.

Interventions: Left Stellate Ganglion Block (LSGB) was performed under ultrasound-assisted injection at the C6 level using a 10 ml solution of 0.4% lidocaine and 0.5% bupivacaine.

Outcomes: In our case, refractory VT subsided and sinus rhythm was retained immediately after LSGB. There were no VT episodes for at least 3 hours during the inter-hospital transfer, which did not involve any specific complications.

Lessons: LSGB may provide effective VT control and play an important role in rescue and bridge therapy before catheter ablation.

Publication types

  • Case Reports

MeSH terms

  • Autonomic Nerve Block / methods*
  • Cardiomyopathies / complications
  • Cardiomyopathies / therapy*
  • Humans
  • Male
  • Middle Aged
  • Stellate Ganglion*
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / therapy*
  • Treatment Outcome