Ultrasound-guided stellate ganglion block in patients with electrical storm: A single-center case series
Main finding · Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h before vs after first SGBResult — go to the resultMedian difference −5.5 95 % CI −9.5 to −3.0Authors' conclusion
SGB appears to be a safe and effective treatment that may provide temporary stabilization between the onset of ES and catheter ablation, while also aiding in the management of persistent ES post-catheter ablation and newly developed ES following cardiac surgery.
Study context
- Population
- Patients with electrical storm (ES) treated with ultrasound-guided stellate ganglion block (SGB), July 2023–July 2024
- Participants
- 20 patients
- Exposure
- Before vs after SGB
- Outcome
- Changes in sustained ventricular arrhythmias and anti-tachycardia pacing (ATP) or defibrillation shocks; effectiveness = ≥ 50 % reduction post-block
- Follow-up
- 24 h before and after SGB
Methodological detailssingle-centre, 60 % persistent ES after catheter ablation, 20 % diagnosed on emergency admission, 15 % ES after cardiac surgery
- Single-centre
- 60 % persistent ES after catheter ablation, 20 % diagnosed on emergency admission, 15 % ES after cardiac surgery
Main finding
As reported in the abstract
Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h before vs after first SGB · 24 h after first SGB
Median difference
−5.5
95 % CI −9.5 to −3.0
P = 0.001
By group
Before SGB
4.5
median · IQR 3.0–13.0
After first SGB
0
median · IQR 0–1.0
After first SGB vs Before SGB
median difference −5.5 (95 % CI −9.5 to −3.0); P = 0.001
- ATP or shocks, median (IQR) before SGB
- 1.5 (0-4.0)
- ATP or shocks, median (IQR) after first SGB
- 0 (0-0.75)
- ATP or shocks, median difference
- −2.0 (95 % CI −4.5 to −0.5, p = 0.011)
- ATP or shocks, effectiveness rate
- 78.6 %
Observational data: associations, not effects.
Further findings
| Outcome | After last SGB | Median difference (95 % CI) | P value | |
|---|---|---|---|---|
| Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h after last SGB vs baselineSustained ventricular arrhythmias | median 0 (IQR 0–0.75) | −5.0 (−10.5 to −2.5) | P = 0.004 | |
| Effectiveness rate | 80.0 % | |||
| −15−10−505Difference (linear scale) |
- Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h after last SGB vs baseline — ATP or shock events, median (IQR) at baseline
- 1.5 (0-4.0)
- Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h after last SGB vs baseline — ATP or shock events, median (IQR) after last SGB
- 0 (0-0)
- Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h after last SGB vs baseline — ATP or shock events, median difference
- −1.75 (95 % CI −12.5 to −0.5, p = 0.028)
- Sustained ventricular arrhythmias (number) and ATP or shocks, within 24 h after last SGB vs baseline — ATP or shock events, effectiveness rate
- 86.7 %
Safety
Minor complications after SGB
- Patients with minor complications
- 10 %
- Hoarseness
- 1
- Phrenic nerve block
- 1
- Both fully recovered without sequelae
Original publication
Ultrasound-guided stellate ganglion block in patients with electrical storm: A single-center case series. J Clin Anesth. Published 2 May 2025. doi:10.
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