Continuous Thoracic Paravertebral Block to Treat Electrical Storm

Author:

Smith Daryl I.1,Kralovic Sarah A.1,Hegazy Rafeek A.1,Tran Hai2

Affiliation:

1. Acute Pain Service, School of Medicine and Dentistry, University of Rochester, Rochester, New York

2. Pediatric Anesthesiology Division, Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, New York

Abstract

Continuous ganglion block is increasingly being used to help manage ventricular tachyarrhythmias. We present the cases of 2 patients in whom we used continuous left thoracic paravertebral block to achieve sympathetic denervation and improvement in drug-refractory ventricular tachyarrhythmias. Whether as destination therapy or bridging therapy, we conclude that the block is safe, improves patients' comfort, and is superior in several ways to stellate ganglion block and other single-injection techniques.

Publisher

Texas Heart Institute Journal

Subject

Cardiology and Cardiovascular Medicine

Reference16 articles.

1. Use of thoracic epidural anesthesia for management of electrical storm: a case report;Mahajan;Heart Rhythm,2005

2. Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery;Collura;Heart Rhythm,2009

3. Left stellate ganglion block for continuous ventricular arrhythmias during percutaneous left ventricular assist device support;Loyalka;Tex Heart Inst J,2011

4. Percutaneous inferior cervical sympathetic ganglion blockade for the treatment of ventricular tachycardia storm: case report and review of the literature;Malik;J Vasc Interv Neurol,2014

5. Trial ultrasound-guided continuous left stellate ganglion blockade before surgical gangliolysis in a patient with a left ventricular assist device and intractable ventricular tachycardia: a pain control application to a complex hemodynamic condition;Smith;ASAIO J,2015

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