Percutaneous stellate ganglion block in the treatment of incessant ventricular tachycardia and ventricular fibrillation

Treatment of ventricular arrhythmias, especially electrical storm or incessant ventricular tachycardia (VT), remains a therapeutic challenge due to the limited possibilities of pharmacotherapy. The possibility of electrophysiological diagnostics and ablation of the arrhythmic substrate allows to effectively prevent the recurrence of VT. Often, though, a serious general condition of the patient and the progress of myocardial dysfunction prevents from conducting an effective ablation procedure. The method that can interrupt an electric storm or incessant VT is the blockade of the sympathetic nervous system, which is responsible for the adrenergic stimulation of the heart. This is achievable by blocking the stellate ganglion (SGB). The cases of sympathetic denervation described in the literature include cases of surgical excision of the ganglion or percutaneous block with the use of anesthetics. The use of SGB enables the termination of life-threatening arrhythmias and improvement of the patient’s clinical condition, which is often a prerequisite for administering electrophysiological treatment or transferring the patient to a center having the capability to apply mechanical circulatory support.