Efficacy of Stellate Ganglion Block for Refractory Ventricular Arrhythmias: An Updated Systematic Review

Document Type

Conference Proceeding

Publication Date

11-7-2023

Publication Title

Circulation

Abstract

ackground: Stellate ganglion block (SGB) has emerged as an alternative approach to refractory ventricular arrhythmias (VAs). However, data on the outcome of SGB for refractory VAs are limited.

Objective: This study aimed to assess the in-hospital efficacy of SGB in refractory VAs.

Method: A systematic search was performed in MEDLINE and EMBASE according to the PRISMA guidelines from July 2017 to October 2022. Studies reporting the characteristics of in-hospital VAs before and after the SGB were included. Studies that had missing outcomes were excluded.

Results: Of 515 publications reviewed, 162 patients (60.6 ± 13.6 years of age, 81.5% male) were included across 27 studies. Amongst, 103 patients (63.6%) had ischemic cardiomyopathy, and the mean ejection fraction was 29.8 ± 12.7%. Prior to the SGB procedure, 100 patients (61.7%) required two or more anti-arrhythmic medications control. Following SGB, there was a significant 92% reduction of VAs episodes from 13.9 ± 18.5 to 0.9 ± 2.1 (p<0.01) during the hospitalization (31±35 days). Of the reported patients, 46.5% remained free of VAs, and 53.5% had recurrences before discharge. Among 61 patients who required additional neuromodulation after SGB in the same hospitalization, 32 patients (52.5%) received repeated SGB, 15 patients (24.6%) underwent surgical sympathectomy, and 14 patients (23%) underwent catheter ablation. Of the reported patients, 75.4% of patients survived throughout the hospital course.

Conclusion: SGB significantly reduced VAs episodes in patients with refractory VAs during hospitalization. More than three-quarters of the patients survived following the SGB for refractory VAs. This highlights the potential effective role of SGB in managing refractory VAs.

Volume

148

Issue

Suppl 1

First Page

A13790

Comments

American Heart Association Scientific Sessions, November 11-13, 2023, Philadelphia, PA

DOI

10.1161/circ.148.suppl_1.13790

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