A Paradoxical Increase in Ventricular Arrhythmia After a Left Stellate Ganglion Block: A Case Report
Sharon M Bouvette1, Amir L Butt, Aimee Pak
1From the Department of Anesthesiology, Oklahoma University Health Campus, Oklahoma City, Oklahoma.
Abstract:
Ultrasound-guided left-sided or bilateral stellate ganglion block (SGB) has emerged as an effective bedside intervention for malignant ventricular arrhythmias (VA) refractory to conventional therapies, with demonstrated safety and efficacy in multiple studies. We report a medically complex patient with presumed genotype-negative Long QT Syndrome (LQTS) who experienced a sudden, transient increase in arrhythmic events shortly after an uncomplicated left-sided ultrasound-guided SGB. To our knowledge, this is the first documented case of increased VA burden following left-sided SGB, highlighting the potential for paradoxical effects and the need for cautious application in patients with comorbidities.
Related Concept Videos
Drugs Acting on Autonomic Ganglia: Blockers
Dysrhythmias IV: Characteristics of Bradyarrhythmias
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Mechanism of Cardiac Arrhythmias
Depolarizing Blockers: Mechanism of Action
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...


