Grossman M A
Arch Intern Med. 1976 Feb;136(2):203-7.
Cardiac rhythm disturbances and ECG wave-form abnormalities have been described with CNS disease or injury in experimental animals and in man. Unilateral sympathetic stimulation has been shown to produce similar changes in ventricular repolarization and reduce the fibrillation threshold. A patient with a ruptured congenital aneurysm of the basilar artery developed an accelerating ventricular tachycardia associated with an episode of active intracranial bleeding. The rhythm disturbance proved refractory to all modalities of chemotherapy, including lidocaine, phenytoin, atropine, procainamide, digoxin, and propranolol. The ECG showed a repolarization abnormality similar to that described with left stellate ganglion stimulation. Left stellate ganglion block was carried out with 15 ml of 1% lidocaine. An effect on the tachyarrhythmia was noted in five minutes. By 15 minutes, the rhythm disturbance was abolished. The repolarization abnormalities improved over a period of hours. Successful management with left stellate ganglion block suggests that this form of therapy may have clinical application in arrhythmias associated with CNS disease.
在实验动物和人类中，已经发现中枢神经系统疾病或损伤会导致心律紊乱和心电图波形异常。单侧交感神经刺激已被证明会使心室复极产生类似变化，并降低颤动阈值。一名患有基底动脉先天性动脉瘤破裂的患者出现了加速性室性心动过速，伴有一次活动性颅内出血发作。事实证明，包括利多卡因、苯妥英钠、阿托品、普鲁卡因胺、地高辛和普萘洛尔在内的所有化疗方法都无法控制这种心律紊乱。心电图显示出与左侧星状神经节刺激所描述的类似的复极异常。用15毫升1%的利多卡因进行了左侧星状神经节阻滞。五分钟后注意到对快速心律失常有影响。到15分钟时，心律紊乱被消除。复极异常在数小时内有所改善。左侧星状神经节阻滞的成功治疗表明，这种治疗形式可能在与中枢神经系统疾病相关的心律失常中具有临床应用价值。
