Sympathetically induced atrial tachycardia. Successful treatment by left stellate ganglion block.
An unusual type of atrial tachycardia was observed in a 52-year-old woman. The tachycardia occurred only when the patient kept the left upper limb in the lateral and horizontal position. Propranolol, atropine sulfate, carotid sinus massage and ocular compression were not effective in terminating or preventing the arrhythmia. Left stellate ganglion block has stopped the tachycardia for at least two years. The atrial tachycardia in this patient was thought to be caused by mechanical stimulation of the left stellate ganglion resulting in pacemaker shifting, as has been demonstrated in the canine heart.
D000200:Action Potentials / Q000187:drug effects; D002045:Bupivacaine / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D013233:Stellate Ganglion / Q000187:drug effects / Q000503:physiopathology*; D013614:Tachycardia, Paroxysmal / Q000188:drug therapy / Q000503:physiopathology*
D002045:Bupivacaine