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Ultrasound-Assisted Stellate Ganglion Block for Managing Refractory Sympathetically Mediated Arrhythmias After Acute Myocardial Infarction: A Guide and Case Illustrations
To evaluate the efficacy and safety of ultrasound-guided stellate ganglion block (SGB) as a rescue therapy for refractory ventricular arrhythmias and one case of rapid atrial flutter following acute myocardial infarction (AMI).
Approach:
Key Findings:
SGB successfully aborted electrical storm in all 5 patients (100%).
Median number of defibrillations per patient decreased significantly from 4 (IQR: 2.5–21) before SGB to 0 (IQR: 0–1) after SGB.
Ipsilateral Horner syndrome developed in all cases, confirming successful sympathetic blockade.
No procedure-related complications were observed.
Interpretation:
SGB is a safe and effective bedside intervention for terminating and stabilizing refractory sympathetic arrhythmia in post-AMI patients.
Limitations:
Small sample size of only five patients.
Retrospective nature of the study limits generalizability.
Conclusion:
SGB can serve as an important adjunctive therapy to reduce the need for repeated electrical defibrillation in patients with refractory arrhythmias post-AMI.
Moderate coffee consumption generally appeared safe for most adults, but randomized evidence suggested divergent effects on atrial fibrillation and premature ventricular contractions.