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Stellate Ganglion Block to Increase Defibrillation Effectiveness in Acute Fulminant Myocarditis-Induced Refractory

Arianna Morena1, Carol Gravinese2, Simone Frea2

  • 1Department of Medical Sciences, University of Turin, Turin, Italy.

JACC. Case Reports
|June 20, 2025
PubMed

Insights

Percutaneous left stellate ganglion block (PLSGB) successfully restored sinus rhythm in a patient with refractory ventricular fibrillation (VF) due to acute fulminant myocarditis. This neuromodulation technique improved defibrillation effectiveness when standard methods failed.

Area of Science:

  • Cardiology
  • Neuromodulation
  • Critical Care Medicine

Background:

  • Percutaneous left stellate ganglion block (PLSGB) is utilized for preventing ventricular arrhythmia recurrences.
  • Limited clinical data exists on PLSGB's effect on ventricular fibrillation (VF) defibrillation thresholds, primarily in acute coronary syndromes.

Observation:

  • A case of refractory VF in acute fulminant myocarditis is presented.
  • The VF was unresponsive to multiple defibrillation attempts, including advanced techniques like double sequential and vector change defibrillation, despite pharmacological and mechanical support.

Findings:

  • PLSGB was administered to a patient with refractory VF secondary to acute fulminant myocarditis.
  • Following PLSGB, stable sinus rhythm was successfully restored, indicating enhanced defibrillation effectiveness.

Implications:

  • This case highlights the potential of acute neuromodulation strategies, specifically PLSGB, in improving defibrillation success.
  • The findings suggest PLSGB may be a valuable adjunctive therapy for refractory VF, particularly in the context of acute myocarditis.
  • This represents the first reported use of PLSGB for refractory VF induced by acute fulminant myocarditis.
Abstract

Keywords:
acute heart failurecardiac magnetic resonanceventricular fibrillation

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