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. 

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
Tong

Betty Caroline Tong

Associate Professor of Surgery
Piccini

Jonathan Paul Piccini

Professor of Medicine

Jonathan P. Piccini, MD, MHS, FACC, FAHA, FHRS is a clinical cardiac electrophysiologist and Professor of Medicine and Population Health at Duke University Hospital and the Duke Clinical Research Institute. He is the Director of the Cardiac Electrophysiology section at the Duke Heart Center. His focus is on the care of patients with atrial fibrillation and complex arrhythmias, with particular emphasis on catheter ablation, pacing, and lead extraction. His research interests include the development and evaluation of innovative cardiovascular interventions for the treatment of heart rhythm disorders. He serves on the Board of Trustees of the Heart Rhythm Society, is an Associate Editor at JACC: Clinical Electrophysiology, and is an elected member of the American Society for Clinical Investigation. Dr. Piccini has more than 600 publications in the field of heart rhythm medicine and has been the recipient of several teaching and mentorship awards.

Fudim

Marat Fudim

Associate Professor of Medicine

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