Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: A systematic review and meta‐analysis

Fudim, Marat; Boortz-Marx, Richard L.; Garg, Arun; Waldron, Nathan H.; Qadri, Yawar J.; Patel, Chetan B.; Milano, Carmelo A.; Sun, Albert Y.; Mathew, Joseph P.; Piccini, Jonathan P.

doi:10.1111/jce.13324

Cited by 85 publications

(48 citation statements)

References 41 publications

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“…The latter distributes to the cardiac plexus, receiving and integrating the afferent and efferent signals and thus regulating heart function [25]. Stellate ganglion block is widely used in the treatment of heart diseases [26]. Stellate ganglion neurons are often surrounded by satellite glial cells (SGCs) [27].…”

Section: Introductionmentioning

confidence: 99%

Involvement of P2Y12 receptor of stellate ganglion in diabetic cardiovascular autonomic neuropathy

Guo

Xuan

et al. 2018

Purinergic Signalling

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Diabetes as a chronic epidemic disease with obvious symptom of hyperglycemia is seriously affecting human health globally due to the diverse diabetic complications. Diabetic cardiovascular autonomic neuropathy (DCAN) is a common complication of both type 1 and type 2 diabetes and incurs high morbidity and mortality. However, the underlying mechanism for DCAN is unclear. It is well known that purinergic signaling is involved in the regulation of cardiovascular function. In this study, we examined whether the P2Y receptor could mediate DCAN-induced sympathetic reflexes. Our results revealed that the abnormal changes of blood pressure, heart rate, heart rate variability, and sympathetic nerve discharge were improved in diabetic rats treated with P2Y short hairpin RNA (shRNA). Meanwhile, the expression of P2Y receptor, interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and connexin 43 (Cx43) in stellate ganglia (SG) was decreased in P2Y shRNA-treated diabetic rats. In addition, knocking down the P2Y receptor also inhibited the activation of p38 MARK in the SG of diabetic rats. Taken together, these findings demonstrated that P2Y receptor in the SG may participate in developing diabetic autonomic neuropathy, suggesting that the P2Y receptor could be a potential therapeutic target for the treatment of DCAN.

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Section: Introductionmentioning

confidence: 99%

Involvement of P2Y12 receptor of stellate ganglion in diabetic cardiovascular autonomic neuropathy

Guo

Xuan

et al. 2018

Purinergic Signalling

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“…A systematic review created by Fudim et al mentioned that ventricular arrhythmia burden was reduced with SGB; however, randomized controlled trials are required for approval of the efficacy and safety of SGB [21].…”

Section: Discussionmentioning

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

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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.

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“…There is increasing interest in the modulation of the autonomic nerve system (ANS) in the treatment of ventricular arrhythmias [1,[7][8][9][10][11]. The simplest and the most commonly used method of ANS modulation is b-blocker administration [1,8].…”

Section: Discussionmentioning

confidence: 99%

“…In the recently published meta-analysis on SGB, bupivacaine and ropivacaine were the most frequently used local anaesthetics, but lidocaine was used as well [10].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous stellate ganglion block as an adjunctive therapy in the treatment of incessant ventricular tachycardia

Przybylski¹,

Romanek²,

Chlebuś³

et al. 2018

Kardiol Pol

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Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: A systematic review and meta‐analysis

Abstract: Early experience suggests that SGB is associated with an acute reduction in the VA burden and offers potential promise for a broader use in high-risk populations. Randomized controlled studies are needed to confirm the safety and efficacy of this therapy.

Cited by 85 publications

References 41 publications

Involvement of P2Y12 receptor of stellate ganglion in diabetic cardiovascular autonomic neuropathy

Involvement of P2Y12 receptor of stellate ganglion in diabetic cardiovascular autonomic neuropathy

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

Percutaneous stellate ganglion block as an adjunctive therapy in the treatment of incessant ventricular tachycardia

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