Less invasive durable management of postoperative ventricular tachycardia storm after LVAD insertion

Ventricular tachycardia (VT) can be a challenging problem in patients following durable left ventricular device (LVAD) implantation, and can lead to significant morbidity and mortality. Both the etiology and management of VT in this population can also vary substantially.

We herein report a case of a patient with preoperative VT who developed a drug resistant VT storm postoperatively that was ultimately controlled durably with a bedside stellate ganglion block.

This case illustrates that stellate ganglion block can be an effective and durable intervention for terminating refractory VT in LVAD patients. This method is attractive because it can be performed at the bedside in relatively unstable patients, and is less invasive than other alternatives such as VT ablation and thoracic sympathectomy.