Acute effects of unilateral temporary stellate ganglion block on human atrial electrophysiological properties and atrial fibrillation inducibility

Leftheriotis, Dionyssios; Flevari, Panayota; Kossyvakis, Charalampos; Katsaras, Dimitrios; Batistaki, Chrysanthi; Arvaniti, Chrysa; Γιαννόπουλος, Γεώργιος; Deftereos, Spyridon; Kostopanagiotou, Georgia; Lekakis, John

doi:10.1016/j.hrthm.2016.06.025

Cited by 45 publications

(25 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4, 19, 20 In humans, unilateral temporary stellate ganglion block might reduce AF inducibility and decrease AF duration. 21 The neural mechanisms of AF is further substantiated by randomized controlled clinical trials that showed pulmonary vein isolation (PVI) plus GP ablation offered a 20–25% higher success rate compared to PVI alone in patients with AF. 22, 23 Another randomized trial showed that botulinum toxin injection in epicardial fat pads can prevent recurrences of AF after cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation

et al. 2017

View full text Add to dashboard Cite

Background Skin sympathetic nerve activity (SKNA) is useful in estimating sympathetic tone in humans Objective To test the hypothesis that (1) increased SKNA is associated with the onset and termination of paroxysmal atrial tachycardia (AT) and AF and (2) The sinoatrial node (SAN) response to SKNA is reduced in patients with more frequent of AT or AF. Methods SKNA and electrocardiogram were recorded in 11 patients (4 males and 7 females, average age 66±10 years), including 3 patients with AT (11±18 episodes/patient) and 8 patients with AF (24±26 episodes/patient). Results The average SKNA (aSKNA, in μV) 10 s prior to AT onset were 1.07±0.10; 10 s after termination were 1.27±0.10, both were significantly (p=0.032, p<0.0001) higher than that during sinus rhythm (0.97±0.09). The aSKNA 10 s prior to AF onset were 1.34±0.07 and 10 s after termination were 1.31±0.07. Both were significantly (p<0.0001) higher than that during sinus rhythm (1.04±0.07). The aSKNA before onset (p<0.0001) and after termination (p= 0.0011) were both higher in AF than in AT. The sinus rate correlated (p<0.0001) with aSKNA in each patient (average r: 0.74, 95% confidence interval (CI): 0.65–0.84). The r in each patient negatively correlated with the number of AT and AF episodes (r= − 0.6493, 95% confidence interval: −0.8990 to −0.08073, p=0.0306). Conclusions Increased SKNA was observed both at onset and termination of AT and AF. The patients with more frequent AT and AF episodes had less of a correlation between sinus rate and aSKNA, suggesting SAN remodeling by tachycardia.

show abstract

Section: Discussionmentioning

confidence: 99%

Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation

et al. 2017

View full text Add to dashboard Cite

show abstract

“…An experimental study was done in 2018 by Lefthiorites et al [10]; it involved the electrophysiologic properties of the left atrium and the inducibility of AF in 36 patients who suffered paroxysmal atrial fibrillation. The study denoted that unilateral SGB reduced the effective refractory period of the left atrium, shortened the duration and the incidence of AF.…”

Section: Discussionmentioning

confidence: 99%

“…Atrial fibrillation as the most common postoperative arrhythmia can be inhibited through SGB. Such block can regulate the autonomic and immune function in such a way to prevent the occurrence and maintenance of AF [10,11].…”

Section: Introductionmentioning

confidence: 99%

Preoperative left stellate ganglion block: Does it offer arrhythmia-protection during off-pump CABG surgery? A randomized clinical trial

Allah

Bakr

Abdelrahman

et al. 2020

Egyptian Journal of Anaesthesia

View full text Add to dashboard Cite

Background: Cardiac arrhythmias are not uncommon during and after coronary artery bypass graft cardiac surgeries. Preliminary studies showed the preventive effects of stellate ganglion block upon cardiac arrhythmias; however, this could be the 1 st study focusing upon intraoperative arrhythmias during offpump coronary artery bypass graft surgery as a main goal. Methods: This is a randomized controlled trial. The study involved forty adult patients undergoing elective offpump coronary artery bypass graft surgery. Twenty patients received left SGB with 10 ml of 2% lidocaine before induction of anesthesia (B group), and twenty patients as a control group (A group). Intraoperative and 24-hours postoperative electrocardiogram and hemodynamics were monitored, in addition to the mean postoperative 24-hours inotropic score. Results: There was a significantly higher incidence of intraoperative arrhythmias in the control group in the form of bradyarrhythmia (25%), supraventricular tachycardia (30%), atrial fibrillation (5%), ventricular tachycardia (10%), and ventricular fibrillation (5%) in comparison to the block group where atrial fibrillation occurred only in 4 patients (20%) with the p value of 0.007. Mean arterial blood pressure and heart rate showed significantly lower values in the SGB group intraoperatively. Postoperative mean 24-hour inotropic score and hemodynamics showed insignificant differences. Conclusion: Preoperative left stellate ganglion block can decrease incidence of arrhythmias during offpump coronary artery bypass graft surgeries. The technique showed a safe profile upon hemodynamics during the study period.

show abstract

“…For the ultrasound-guided SGB, each patient will receive 6 mL 1% lidocaine and 6 mL normal saline at one-week intervals to allow a washout period for the injection. The 1% lidocaine is composed of 2% lidocaine and normal saline in a 1:1 ratio (for example, the 1% lidocaine 2 mL is prepared by combining 2% lidocaine 1 mL, and normal saline 1 mL) [ 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of ultrasound-guided stellate ganglion block on cervical vascular blood flow: study protocol for a randomized controlled trial

Chen

et al. 2018

Trials

View full text Add to dashboard Cite

BackgroundThe stellate ganglion block (SGB) can lead to vasodilation of the head and neck. However, controversy remains concerning the changes in extracerebral blood flow. The objective of this study is to assess the effects of SGB on the blood flow to the neck.MethodsA randomized controlled crossover trial with 38 participants will be conducted. Participants who have primary headaches will be assigned to either group A or B. Patients in group A will receive SGB with 6 ml 1% lidocaine, and after a one-week washout period, they will undergo the second SGB with 6 ml normal saline. In contrast, patients in group B will receive the opposite protocol. Data will be collected at baseline (T0) and at 15 min after the first intervention (T1), 15 min before the second intervention (T2), 15 min after the second intervention (T3) and at a 3-week follow up (T4). T1 is the primary time point for the primary outcome analysis. The primary outcomes include the peak systolic velocity (PSV), the end diastolic velocity (EDV), resistance index (RI) and vessel diameter of the common carotid artery (CCA) and vertebral artery (VA). The secondary outcomes include the rate of ptosis, the rate of conjunctival flushing, and the numerical rating scale (NRS) pain score. Additionally, adverse events (AEs) or serious adverse events (SAEs) will be collected at each assessment point.DiscussionThis study will comprehensively investigate the efficacy of SGB in extracerebral blood flow. Our research may also suggest that SGB will be effective in reducing pain in patients with primary headaches.Trial registrationChinese Clinical Trial Registry, identifier ChiCTR-IOR-17011536. Registered on 1 June 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2736-y) contains supplementary material, which is available to authorized users.

show abstract

Acute effects of unilateral temporary stellate ganglion block on human atrial electrophysiological properties and atrial fibrillation inducibility

Cited by 45 publications

References 34 publications

Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation

Skin sympathetic nerve activity precedes the onset and termination of paroxysmal atrial tachycardia and fibrillation

Preoperative left stellate ganglion block: Does it offer arrhythmia-protection during off-pump CABG surgery? A randomized clinical trial

Effects of ultrasound-guided stellate ganglion block on cervical vascular blood flow: study protocol for a randomized controlled trial

Contact Info

Product

Resources

About