Stellate Ganglion Block as a Bridge to Cardiac Sympathectomy for Treating Recurrent Ventricular Tachycardia in a...

Stellate ganglion block is a salvage therapy used for refractory or incessant ventricular tachycardia when conservative measures have failed.

This case involves a man in his 60s with a history of hypertension, glaucoma, heart failure with a reduced ejection fraction of 28%, and 2 stents at the mid left anterior descending artery and proximal right coronary artery following a recent myocardial infarction. After his initial presentation, he was found to be in sustained ventricular tachycardia, in addition to having a right brachial vein deep vein thrombosis for which he was started on rivaroxaban. He had several major risk factors, including triple anticoagulant therapy, glaucoma, recent myocardial infarction, and cardiac conduction block. Since he was a poor candidate for heart transplantation and after weighing risks vs benefits, he underwent a stellate ganglion block. No immediate postprocedure complications occurred. He had terminal cardiac sympathectomy afterwards.

While stellate ganglion block is not a novel technique, this case demonstrated the feasibility for performing it for refractory ventricular tachycardia in select high-risk patients.