Fudim Marat, Boortz-Marx Richard, Patel Chetan B, Sun Albert Y, Piccini Jonathan P
Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA.
Duke Anesthesiology, Duke University, Durham, North Carolina, USA.
J Cardiovasc Electrophysiol. 2017 Apr;28(4):446-449. doi: 10.1111/jce.13152. Epub 2017 Jan 11.
Ventricular tachycardia (VT), ventricular fibrillation (VF), and electrical storm are commonly encountered emergency conditions in cardiac and surgical intensive care units. In most cases, recurrent ventricular arrhythmias or electrical storm are associated with a heightened sympathetic tone. These arrhythmias can be difficult to treat and may be refractory to beta-blockade, antiarrhythmic therapy, sedation, and mechanical hemodynamic support. While monomorphic ventricular tachycardia and PVC-triggered polymorphic ventricular tachycardia may sometimes be amenable to successful ablation, some patients may be too critically ill to make such an approach feasible. We present 2 cases of minimally invasive stellate ganglion blocks for the treatment of electrical storm in patients with advanced heart failure on mechanical life support. These cases are part of a collaborative initiative at our institution to use percutaneous stellate ganglion block as an adjunctive intervention to achieve control of life-threatening ventricular arrhythmias.
室性心动过速（VT）、心室颤动（VF）和电风暴是心脏及外科重症监护病房常见的紧急情况。在大多数情况下，复发性室性心律失常或电风暴与交感神经张力增高有关。这些心律失常可能难以治疗，并且可能对β受体阻滞剂、抗心律失常治疗、镇静和机械血流动力学支持无效。虽然单形性室性心动过速和PVC触发的多形性室性心动过速有时可通过成功消融治疗，但一些患者病情过于危重，无法采用这种方法。我们报告2例在接受机械生命支持的晚期心力衰竭患者中，采用微创星状神经节阻滞治疗电风暴的病例。这些病例是我们机构一项合作计划的一部分，该计划旨在使用经皮星状神经节阻滞作为辅助干预措施，以控制危及生命的室性心律失常。
