Ultrasound-Assisted Stellate Ganglion Block for Managing Refractory Sympathetically Mediated Arrhythmias After Acute Myocardial Infarction: A Guide and Case Illustrations
By
Ranwei Yao
Yingjie Che
Xiuling Wu
June 19, 2026
Clinical Scorecard: Ultrasound-Assisted Stellate Ganglion Block for Managing Refractory Sympathetically Mediated Arrhythmias After Acute Myocardial Infarction: A Guide and Case Illustrations
At a Glance
Category Detail
Condition Refractory Sympathetically Mediated Arrhythmias Key Mechanisms Ultrasound-guided stellate ganglion block (SGB) modulates cardiac sympathetic tone. Target Population Patients post-acute myocardial infarction (AMI) with refractory arrhythmias. Care Setting Bedside intervention in acute care settings.
Key Highlights
SGB successfully aborted electrical storm in all 5 patients (100%). Median defibrillations per patient decreased from 4 to 0 after SGB. Ipsilateral Horner syndrome confirmed successful sympathetic blockade. No procedure-related complications were observed. SGB serves as an adjunctive therapy to reduce repeated electrical defibrillation. Guideline-Based Recommendations
Diagnosis
Identify refractory sympathetically mediated arrhythmias post-AMI. Management
Consider ultrasound-guided SGB for patients unresponsive to standard medical management. Monitoring & Follow-up
Monitor for development of Horner syndrome as a sign of successful block. Risks
Potential for local anesthetic toxicity, though minimized with lower volume. Patient & Prescribing Data
Five AMI patients of Han ethnicity, aged 29 to 87 years.
1% lidocaine hydrochloride used for SGB, with 5 mL being effective and safe.
Clinical Best Practices
Perform SGB at the bedside or in a catheterization laboratory by trained anesthesiologists. Use ultrasound guidance to enhance safety and accuracy of the procedure. Prioritize patient safety by using lower volumes of local anesthetic in hemodynamically unstable patients. Related Resources & Content
