Ultrasound-Assisted Stellate Ganglion Block for Managing Refractory Arrhythmias

Overview

This case series evaluates the efficacy and safety of ultrasound-guided stellate ganglion block (SGB) in five patients with refractory sympathetically mediated arrhythmias following acute myocardial infarction (AMI). SGB successfully terminated arrhythmias in all cases.

Background

Sympathetic arrhythmias can occur after acute myocardial infarction and are often resistant to standard treatments. Stellate ganglion block (SGB) has emerged as a potential intervention to modulate cardiac sympathetic tone and manage these arrhythmias. The introduction of ultrasound guidance enhances the safety and accuracy of this procedure.

Data Highlights

Key Findings

• All 5 patients experienced successful termination of electrical storm (100% success rate).
• The median number of defibrillations per patient decreased significantly after SGB.
• All patients developed ipsilateral Horner syndrome, indicating successful sympathetic blockade.
• No procedure-related complications were observed.

Clinical Implications

Ultrasound-guided SGB may be considered a safe and effective bedside intervention for managing refractory sympathetically mediated arrhythmias in post-AMI patients.

Conclusion

Ultrasound-guided SGB demonstrates promise as a rescue therapy for refractory arrhythmias following AMI.

Related Resources & Content

1. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes | JACC, 2024 -- Electrical Complications and Prevention of Sudden Cardiac Death After ACS
2. Stellate ganglion block for refractory ventricular arrhythmias: an updated systematic review - PubMed
3. Efficacy of percutaneous stellate ganglion block according to ventricular arrhythmia cycle length: A post hoc subanalysis of the STAR study - ScienceDirect
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8. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | JACC
9. https://academic.oup.com/eurheartj/article/45/10/823/7592053
10. Efficacy of percutaneous stellate ganglion block according to ventricular arrhythmia cycle length: A post hoc subanalysis of the STAR study - ScienceDirect
11. Stellate ganglion block for refractory ventricular arrhythmias: an updated systematic review - PubMed
12. Stellate ganglion blockade for treatment of ventricular electrical storm: an updated meta-analysis - PMC
13. Stellate Ganglion Block for the Treatment of Refractory Ventricular Tachycardia and Electrical Storm. A Narrative Review - ScienceDirect
14. Spotlight on the 2022 ESC guideline management of ventricular arrhythmias and prevention of sudden cardiac death: 10 novel key aspects | EP Europace | Oxford Academic