Enrico Baldi, Veronica Dusi, Roberto Rordorf, Alessia Currao, Sara Compagnoni, Antonio Sanzo, Francesca Romana Gentile, Simone Frea, Carol Gravinese, Filippo Angelini, Filippo Maria Cauti, Gianmarco Iannopollo, Francesco De Sensi, Edoardo Gandolfi, Laura Frigerio, Pasquale Crea, Domenico Zagari, Matteo Casula, Giulio Binaghi, Giuseppe Sangiorgi, Lucy Barone, Simone Persampieri, Gabriele Dell'Era, Giuseppe Patti, Claudia Colombo, Giacomo Mugnai, Domenico Tavella, Francesco Notaristefano, Alberto Barengo, Roberta Falcetti, Giulia Girardengo, Giuseppe D'Angelo, Nikita Tanese, Vito Sgromo, Gaetano Maria De Ferrari, Simone Savastano
{"title":"Efficacy of early use of Percutaneous Stellate Ganglion Block for electrical storms.","authors":"Enrico Baldi, Veronica Dusi, Roberto Rordorf, Alessia Currao, Sara Compagnoni, Antonio Sanzo, Francesca Romana Gentile, Simone Frea, Carol Gravinese, Filippo Angelini, Filippo Maria Cauti, Gianmarco Iannopollo, Francesco De Sensi, Edoardo Gandolfi, Laura Frigerio, Pasquale Crea, Domenico Zagari, Matteo Casula, Giulio Binaghi, Giuseppe Sangiorgi, Lucy Barone, Simone Persampieri, Gabriele Dell'Era, Giuseppe Patti, Claudia Colombo, Giacomo Mugnai, Domenico Tavella, Francesco Notaristefano, Alberto Barengo, Roberta Falcetti, Giulia Girardengo, Giuseppe D'Angelo, Nikita Tanese, Vito Sgromo, Gaetano Maria De Ferrari, Simone Savastano","doi":"10.1093/ehjacc/zuae109","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Electrical Storm (ES) is a life-threatening condition requiring a rapid management. Percutaneous Stellate Ganglion Block (PSGB) proved to be safe and effective on top of standard therapy, but no data are available about its early use.</p><p><strong>Methods: </strong>We considered all patients enrolled from 1st July 2017 to 30th April 2024 in the STAR registry (STellate ganglion block for Arrhythmic stoRm), a multicentre, international, observational, prospective registry. We aimed to assess the effectiveness of the first PSGB only. Patients were divided into two groups depending on whether they received PSGB before (Early-PSGB, often due to AAD contraindication) or after (Delayed-PSGB) intravenous antiarrhythmic drugs (AADs other than beta-blockers).</p><p><strong>Results: </strong>We considered 180 PSGB (26 Early-PSGB and 154 AAD-first). In the early-PSGB group we observed a statistically significant reduction of treated arrhythmic events in the hour after PSGB compared to the hour before: 0 (0-0) vs 4.5 (1-10), p<0.001 and the extent of the reduction was similar in the Early-PSGB and delayed-PSGB group [-4.5 (-7 to -2) vs. -2.5 (-3.5 to -1.5), p=ns]. The percentage of patients free from arrhythmias was similar in the two groups up to 12 hours after PSGB (81%vs 84%, p=0.6 after one hour; 77% vs 79%, p=0.8 at three hours and 65% vs 69%, p= 0.7 after 12 hours).</p><p><strong>Conclusions: </strong>PSGB proved to be effective also when used early in the treatment of ES. Due to its rapidity of action, our results may suggest its early use to reduce the number of defibrillations and possibly to reduce the likelihood of a refractory ES.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal: Acute Cardiovascular Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjacc/zuae109","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Electrical Storm (ES) is a life-threatening condition requiring a rapid management. Percutaneous Stellate Ganglion Block (PSGB) proved to be safe and effective on top of standard therapy, but no data are available about its early use.
Methods: We considered all patients enrolled from 1st July 2017 to 30th April 2024 in the STAR registry (STellate ganglion block for Arrhythmic stoRm), a multicentre, international, observational, prospective registry. We aimed to assess the effectiveness of the first PSGB only. Patients were divided into two groups depending on whether they received PSGB before (Early-PSGB, often due to AAD contraindication) or after (Delayed-PSGB) intravenous antiarrhythmic drugs (AADs other than beta-blockers).
Results: We considered 180 PSGB (26 Early-PSGB and 154 AAD-first). In the early-PSGB group we observed a statistically significant reduction of treated arrhythmic events in the hour after PSGB compared to the hour before: 0 (0-0) vs 4.5 (1-10), p<0.001 and the extent of the reduction was similar in the Early-PSGB and delayed-PSGB group [-4.5 (-7 to -2) vs. -2.5 (-3.5 to -1.5), p=ns]. The percentage of patients free from arrhythmias was similar in the two groups up to 12 hours after PSGB (81%vs 84%, p=0.6 after one hour; 77% vs 79%, p=0.8 at three hours and 65% vs 69%, p= 0.7 after 12 hours).
Conclusions: PSGB proved to be effective also when used early in the treatment of ES. Due to its rapidity of action, our results may suggest its early use to reduce the number of defibrillations and possibly to reduce the likelihood of a refractory ES.
期刊介绍:
The European Heart Journal - Acute Cardiovascular Care (EHJ-ACVC) offers a unique integrative approach by combining the expertise of the different sub specialties of cardiology, emergency and intensive care medicine in the management of patients with acute cardiovascular syndromes.
Reading through the journal, cardiologists and all other healthcare professionals can access continuous updates that may help them to improve the quality of care and the outcome for patients with acute cardiovascular diseases.