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Meta-Analysis
. 2024 Oct 21;14(1):24719.
doi: 10.1038/s41598-024-76663-9.

Efficacy of stellate ganglion block in treatment of electrical storm: a systematic review and meta-analysis

Pouya Motazedian #  1   2   3 , Nicholas Quinn #  4 , George A Wells  2   3 , Nickolas Beauregard  3 , Eric Lam  5 , Marie-Eve Mathieu  4 , William Knoll  4 , Graeme Prosperi-Porta  1   2 , Valentina Ly  4 , Simon Parlow  1   2   4 , Pietro Di Santo  1   3   4 , Omar Abdel-Razek  1   2 , Richard Jung  1   4 , Trevor Simard  6 , Jacob C Jentzer  6 , Rebecca Mathew  2 , F Daniel Ramirez  2 , Benjamin Hibbert  7
Affiliations
Meta-Analysis

Efficacy of stellate ganglion block in treatment of electrical storm: a systematic review and meta-analysis

Pouya Motazedian et al. Sci Rep. .

Abstract

Electrical storm (ES) is a life-threatening condition of recurrent ventricular arrhythmias (VA) in a short period of time. Percutaneous stellate ganglion blockade (SGB) is frequently used - however the efficacy is undefined. The objective of our systematic review was to determine the efficacy of SGB in reducing VA events and mortality among patients with ES. A search of Medline, EMBASE, Scopus, CINAHL and CENTRAL was performed on February 29, 2024 to include studies with adult patients (≥ 18 years) with ES treated with SGB. Our outcomes of interest were VA burden pre- and post-SGB, and in-hospital/30-day mortality. A total of 553 ES episodes in 542 patients from 15 observational studies were included. Treated VAs pre- and post-SGB were pooled from eight studies including 383 patients and demonstrated a decrease from 3.5 (IQR 2.25-7.25) to 0 (IQR 0-0) events (p = 0.008). Complete resolution after SGB occurred in 190 of 294 patients (64.6%). Despite this, in-hospital or 30-day mortality remained high occurring in 140 of 527 patients (random effects prevalence 22%). Repeat SGB for recurrent VAs was performed in 132 of 490 patients (random effects prevalence 21%). In conclusion, observational data suggests SGB may be effective in reducing VAs in ES. Definitive studies for SGB in VA management are needed. Study protocol: PROSPERO - registration number CRD42023430031.

Keywords: Electrical storm; Meta-analysis; Stellate ganglion block; Systematic Review; Ventricular Electrical Storm; Ventricular arrhythmia.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Median ventricular arrhythmia events requiring external shock or ICD therapies before and after stellate ganglion block for in-hospital follow-up (A) and at 24 h post- stellate ganglion block (C), and median ventricular arrhythmia events before and after stellate ganglion block during in-hospital follow-up (B) and at 24 h post- stellate ganglion block (D). Abbreviations: ICD – implantable cardioverter-defibrillator, VA – ventricular arrhythmia.
See this image and copyright information in PMC

References

    1. Al-Khatib, S. M. et al. 2017 AHA/ACC/HRS Guideline for management of patients with ventricular arrhythmias and the Prevention of Sudden Cardiac Death. Circulation. 138, e272–e391. 10.1161/CIR.0000000000000549 (2018). - PubMed
    1. Deyell, M. W. et al. Canadian Cardiovascular Society/Canadian Heart Rhythm Society Position Statement on the Management of Ventricular Tachycardia and Fibrillation in Patients With Structural Heart Disease. Canadian Journal of Cardiology 36, 822–836, doi: (2020). 10.1016/j.cjca.2020.04.004 (2020). - PubMed
    1. Zeppenfeld, K. et al. ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Developed by the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) Endorsed by the Association for European Paediatric and Congenital Cardiology (AEPC). European Heart Journal 43, 3997–4126, doi: (2022). 10.1093/eurheartj/ehac262 (2022). - PubMed
    1. Jentzer, J. C. et al. Multidisciplinary critical Care Management of Electrical Storm. J. Am. Coll. Cardiol. 81, 2189–2206. 10.1016/j.jacc.2023.03.424 (2023). - PMC - PubMed
    1. Guerra, F. et al. Implantable cardioverter-defibrillator programming and electrical storm: results of the OBSERVational registry on long-term outcome of ICD patients (OBSERVO-ICD). Heart Rhythm. 13, 1987–1992 (2016). - PubMed

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