早期使用经皮星状神经节阻滞治疗电风暴的疗效。

IF 3.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
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
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引用次数: 0

摘要

背景:电风暴(ES)是一种危及生命的疾病,需要快速治疗。经皮星状神经节阻滞(PSGB)被证明是安全有效的标准疗法,但目前还没有关于其早期应用的数据:我们考虑了 STAR 登记(STellate ganglion block for Arrhythmic stoRm)中 2017 年 7 月 1 日至 2024 年 4 月 30 日登记的所有患者,STAR 登记是一项多中心、国际性、观察性、前瞻性登记。我们旨在评估首次 PSGB 的有效性。根据患者是在静脉注射抗心律失常药物(β-受体阻滞剂除外的 AADs)之前(通常由于 AAD 禁忌症)还是之后(延迟-PSGB)接受 PSGB,我们将患者分为两组:我们考虑了 180 例 PSGB(26 例早期-PSGB 和 154 例先使用 AAD 者)。在早期 PSGB 组中,我们观察到 PSGB 后一小时内治疗的心律失常事件比 PSGB 前一小时明显减少:0 (0-0) vs 4.5 (1-10),P 结论:事实证明,在治疗 ES 的早期使用 PSGB 也很有效。由于 PSGB 的快速作用,我们的研究结果表明,早期使用 PSGB 可以减少除颤次数,并有可能降低发生难治性 ES 的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of early use of Percutaneous Stellate Ganglion Block for electrical storms.

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.

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来源期刊
CiteScore
8.50
自引率
4.90%
发文量
325
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.
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