Stellate Ganglion Blockade: an Intervention for the Management of Ventricular Arrhythmias.

Abstract

PURPOSE OF REVIEW:To highlight the indications, procedural considerations, and data supporting the use of stellate ganglion blockade (SGB) for management of refractory ventricular arrhythmias. RECENT FINDINGS:In patients with refractory ventricular arrhythmias, unilateral or bilateral SGB can reduce arrhythmia burden and defibrillation events for 24-72 h, allowing time for use of other therapies like catheter ablation, surgical sympathectomy, or heart transplantation. The efficacy of SGB appears to be consistent despite the type (monomorphic vs polymorphic) or etiology (ischemic vs non-ischemic cardiomyopathy) of the ventricular arrhythmia. Ultrasound-guided SGB is safe with low risk for complications, even when performed on anticoagulation. SGB is effective and safe and could be considered for patients with refractory ventricular arrhythmias.

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Citation

Published Version (Please cite this version)

10.1007/s11906-020-01111-8

Publication Info

Ganesh, Arun, Yawar J Qadri, Richard L Boortz-Marx, Sana M Al-Khatib, David H Harpole, Jason N Katz, Jason I Koontz, Joseph P Mathew, et al. (2020). Stellate Ganglion Blockade: an Intervention for the Management of Ventricular Arrhythmias. Current hypertension reports, 22(12). p. 100. 10.1007/s11906-020-01111-8 Retrieved from https://hdl.handle.net/10161/21665.

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Scholars@Duke

Ganesh

Arun Ganesh

Assistant Professor of Anesthesiology

I am an anesthesiologist and pain medicine specialist. My research focuses on use of sympathetic nerve blocks for treatment of cardiac conditions.  We study the efficacy of stellate ganglion blocks for treatment of refractory ventricular arrhythmias, and splanchnic nerve blocks for treatment of acute and chronic heart failure.  Outside of work I enjoy playing tennis, drums, and spending time with my wife and two sons. 

Al-Khatib

Sana Mustapha Al-Khatib

Professor of Medicine

Dr. Sana M. Al-Khatib is a tenured Professor of Medicine at Duke University Medical Center, a board-certified clinical electrophysiologist and an experienced clinical researcher in cardiac arrhythmias.  She is currently the Director of the Fellowship Program at the Duke Clinical Research Institute.  As a graduate of the NIH-funded Clinical Research Training Program, she is one of a few electrophysiologists nationwide with expertise in quantitative research methods. Her clinical expertise is in sudden cardiac death prevention, atrial fibrillation and ventricular arrhythmias, and implantable cardiac devices. Her research expertise lies in the design and conduct of clinical trials, outcomes research, and cost-effectiveness analyses. She is a recipient of a National Heart, Lung and Blood Institute’s R-01 grant titled “Implantable Cardioverter Defibrillator Therapy in Patients with Heart Failure” (2009-2013) and of an American Heart Association Career Development Award (2002-2006). She is a Co-Principal Investigator on an NHLBI-funded T-32 Postdoctoral Training in Cardiovascular Clinical Research and is a co-investigator on several NIH-funded projects. She has more than 350 publications in peer-reviewed journals. She has established several collaborative research efforts both within and outside her institution. The goals of these collaborations are to synergize efforts aimed at improving the survival and quality of life of patients at risk for sudden cardiac death and those with atrial and ventricular arrhythmias through clinical trials and outcomes-based research and to evaluate study design and data analysis in order to improve the quality of research done in these arenas. Dr. Al-Khatib is a Senior Associate Editor for Circulation and is on the Editorial Board for Circulation: Arrhythmia and Electrophysiology, Heart Rhythm, Journal of Cardiovascular Electrophysiology, JACC:EP, the Cardiovascular Digital Health Journal, and the American Heart Journal. Dr. Al-Khatib has served on multiple national committees including the Heart Rhythm Society Board of Trustees (current), the Heart Rhythm Society Finance Committee (current), the Heart Rhythm Society Audit Committee (current), the Heart Rhythm Society Health Policy committee (past), the Heart Rhythm Society Legislative subcommittee (past), and the Heart Rhythm Society Program Planning committee (past). She chaired the 2017 AHA/ACC/HRS Guideline for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. 

Harpole

David Harold Harpole

George Barth Geller Distinguished Professor for Research in Cancer

A. Non-small cell lung cancer
1. Evaluation of serum and tissue molecular biologic markers of recurrence in patients with a localize non-small cell lung cancer.
2. Molecular biologic staging of lymph nodes in patients with non-small cell lung cancer.
3. The evaluation of the clonality of metastatic tumors in patients with non-small cell lung cancer.

B. Clinical research activities
1. Creation of a prospective database for the Duke Thoracic Oncology Program.
2. A cost and satisfaction evaluation of thoracoscopy and open thoracotomy in patients.
3. Development of risk associated models of morbidity in patients undergoing general thoracic surgery procedures: The VA Cooperative Surgical Risk Study
4. A member of the Duke Gastrointestinal Malignancy Research Committee, developing esophageal cancer treatment protocols and outcome studies.

Koontz

Jason Koontz

Associate Professor of Medicine
Mathew

Joseph P. Mathew

Jerry Reves, M.D. Distinguished Professor of Cardiac Anesthesiology

Current research interests include:
1. The relationship between white matter patency, functional connectivity (fMRI) and neurocognitive function following cardiac surgery.
2. The relationship between global and regional cortical beta-amyloid deposition and postoperative cognitive decline.
3. The effect of lidocaine infusion upon neurocognitive function following cardiac surgery.
4. The association between genotype and outcome after cardiac surgery.
5. Atrial fibrillation following cardiopulmonary bypass.

Ray

Neil Deep Ray

Assistant Professor of Anesthesiology
Sun

Albert Y. Sun

Associate Professor of Medicine

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