Enrico Baldi MD, PhD , Roberto Rordorf MD , Sara Compagnoni MD , Veronica Dusi MD, PhD , Antonio Sanzo MD , Francesca Romana Gentile MD , Simone Frea MD , Carol Gravinese MD , Filippo Maria Cauti MD, PhD , Gianmarco Iannopollo MD , Francesco De Sensi MD , Edoardo Gandolfi MD , Laura Frigerio MD , Pasquale Crea MD, PhD , Domenico Zagari MD , Matteo Casula MD , Giuseppe Sangiorgi MD , Simone Persampieri MD , Gabriele Dell’Era MD , Giuseppe Patti MD , Enrico Chieffo
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引用次数: 0
Abstract
Background
Data on the predictors of percutaneous stellate ganglion block (PSGB) efficacy in electrical storm are scanty.
Objective
We aimed to assess whether PSGB efficacy is influenced by the arrhythmia type and cycle length before the procedure.
Methods
This is a subanalysis of the multicenter STAR study. The population was stratified into 3 groups according to the median cycle length of the latest ventricular arrhythmia before PSGB: ventricular fibrillation (VF), fast ventricular tachycardia (VT), and slow VT. The primary outcome was the number of treated arrhythmic episodes (with antitachycardia pacing or direct current shocks) in the hour immediately after PSGB compared with the hour before.
Results
We considered 139 PSGBs from 112 patients divided into VF (51 procedures), fast VT (44 procedures, VT cycle <375 ms), and slow VT (44 procedures, VT cycle ≥375 ms). The number of treated arrhythmic episodes in the hour after every PSGB was significantly lower compared with the hour before in all groups (VF: 0 [0–1] vs 5 [2–8], P < .001; fast VT: 0 [0–0] vs 1 [0–6.5], P < .001; slow VT: 0 [0–0] vs 1 [0–4.5], P = .001). In analyzing the reduction of the number of antitachycardia pacing sequences or direct current shocks from the hour before to the hour after PSGB, a significant trend was observed across the groups (Jonckheere-Terpstra trend P < .001), and a significant difference was observed in comparing slow VT vs VF and fast VT vs VF but not in comparing slow VT vs fast VT. VF was independently associated with the probability of reduction of treated events after PSGB.
Conclusion
PSGB is an effective treatment of electrical storm in patients with all types of ventricular arrhythmias. However, its effectiveness was more pronounced in patients with VF.
期刊介绍:
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.