Overview
This study will evaluate the acute effect of ultrasound-navigated left ganglion stellate block to suppress ventricular arrhythmia in patients with arrhythmic storm.
Description
- The study will include patients with drug-refractory arrhythmic storm indicated for left
ganglion stellate block (LGSB) before or after catheter ablation.
- Included participants will be dived based on the need for mechanical ventilation and catheter ablation performed <5 days before the study
- Subsequently, the participants will be randomized to LGSB or to a sham (placebo) procedure.
- The primary endpoint will be a reduction of the burden of clinical arrhythmia >50% 24 hours after LGSB without escalation of antiarrhythmic therapy.
- The study will include 80 patients over 4 years.
Eligibility
Inclusion Criteria:
- arrhythmic storm <24 hours before inclusion:
- 3 or more episodes of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) terminated by external or internal shock,
- or incessant VT lasting >30 minutes,
- or very frequent nonsustained or sustained VT leading to hemodynamic instability with the need of escalation of the therapy
- clinical indication for LBGS based on the judgment of the physician, independent of
the study
Exclusion Criteria:
- known allergy to bupivacaine
- prior LBGS performed <7 days before the study
- known reversible provoking trigger of the arrhythmias
- ventricular arrhythmias triggered by premature ectopic beats during bradycardia
- hemodynamically tolerated idiopathic VT in patients without structural heart disease