Stellate ganglion local anesthetic blockade and neurolysis for the treatment of refractory ventricular fibrillation.
Electrical storm (ES) is a syndrome characterized by recurrent ventricular fibrillation or tachycardia. It is a major clinical challenge and is often unresponsive to conventional drug therapy; instead, its treatment requires multiple attempts at electrical defibrillation. Sympathetic hyperactivity is an important modulator of ventricular arrhythmias, including ES. We report a case of ES treated safely and effectively with pharmacologic sympathectomy involving diagnostic continuous stellate ganglion blockade with local anesthetic followed by therapeutic neurolysis. This technique reduced ES in a patient for whom conservative medical and interventional procedures were ineffective.
From the Department of Anesthesiology, University of Florida, Gainesville, Florida.
David F
DF
Hulata
Linda
L
Le-Wendling
Andre P
AP
Boezaart
Robert W
RW
Hurley
D000779:Anesthetics, Local; D001340:Autonomic Nerve Block; D004554:Electric Countershock; D006801:Humans; D008297:Male; D008875:Middle Aged; D013233:Stellate Ganglion / Q000503:physiopathology; D013562:Sympathectomy; D014693:Ventricular Fibrillation / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
D000779:Anesthetics, Local