Electrical storm treatment by percutaneous stellate ganglion block: the STAR study.
Electrical storm
Neuromodulation
Stellate ganglion block
Ventricular tachycardia
Journal
European heart journal
ISSN: 1522-9645
Titre abrégé: Eur Heart J
Pays: England
ID NLM: 8006263
Informations de publication
Date de publication:
07 Mar 2024
07 Mar 2024
Historique:
received:
02
08
2023
revised:
27
11
2023
accepted:
10
01
2024
medline:
11
3
2024
pubmed:
30
1
2024
entrez:
30
1
2024
Statut:
ppublish
Résumé
An electrical storm (ES) is a clinical emergency with a paucity of established treatment options. Despite initial encouraging reports about the safety and effectiveness of percutaneous stellate ganglion block (PSGB), many questions remained unsettled and evidence from a prospective multicentre study was still lacking. For these purposes, the STAR study was designed. This is a multicentre observational study enrolling patients suffering from an ES refractory to standard treatment from 1 July 2017 to 30 June 2023. The primary outcome was the reduction of treated arrhythmic events by at least 50% comparing the 12 h following PSGB with the 12 h before the procedure. STAR operators were specifically trained to both the anterior anatomical and the lateral ultrasound-guided approach. A total of 131 patients from 19 centres were enrolled and underwent 184 PSGBs. Patients were mainly male (83.2%) with a median age of 68 (63.8-69.2) years and a depressed left ventricular ejection fraction (25.0 ± 12.3%). The primary outcome was reached in 92% of patients, and the median reduction of arrhythmic episodes between 12 h before and after PSGB was 100% (interquartile range -100% to -92.3%). Arrhythmic episodes requiring treatment were significantly reduced comparing 12 h before the first PSGB with 12 h after the last procedure [six (3-15.8) vs. 0 (0-1), P < .0001] and comparing 1 h before with 1 h after each procedure [2 (0-6) vs. 0 (0-0), P < .001]. One major complication occurred (0.5%). The findings of this large, prospective, multicentre study provide evidence in favour of the effectiveness and safety of PSGB for the treatment of refractory ES.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
An electrical storm (ES) is a clinical emergency with a paucity of established treatment options. Despite initial encouraging reports about the safety and effectiveness of percutaneous stellate ganglion block (PSGB), many questions remained unsettled and evidence from a prospective multicentre study was still lacking. For these purposes, the STAR study was designed.
METHODS
METHODS
This is a multicentre observational study enrolling patients suffering from an ES refractory to standard treatment from 1 July 2017 to 30 June 2023. The primary outcome was the reduction of treated arrhythmic events by at least 50% comparing the 12 h following PSGB with the 12 h before the procedure. STAR operators were specifically trained to both the anterior anatomical and the lateral ultrasound-guided approach.
RESULTS
RESULTS
A total of 131 patients from 19 centres were enrolled and underwent 184 PSGBs. Patients were mainly male (83.2%) with a median age of 68 (63.8-69.2) years and a depressed left ventricular ejection fraction (25.0 ± 12.3%). The primary outcome was reached in 92% of patients, and the median reduction of arrhythmic episodes between 12 h before and after PSGB was 100% (interquartile range -100% to -92.3%). Arrhythmic episodes requiring treatment were significantly reduced comparing 12 h before the first PSGB with 12 h after the last procedure [six (3-15.8) vs. 0 (0-1), P < .0001] and comparing 1 h before with 1 h after each procedure [2 (0-6) vs. 0 (0-0), P < .001]. One major complication occurred (0.5%).
CONCLUSIONS
CONCLUSIONS
The findings of this large, prospective, multicentre study provide evidence in favour of the effectiveness and safety of PSGB for the treatment of refractory ES.
Identifiants
pubmed: 38289867
pii: 7592053
doi: 10.1093/eurheartj/ehae021
pmc: PMC10919918
doi:
Types de publication
Observational Study
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
823-833Investigateurs
Alessandro Fasolino
(A)
Sara Bendotti
(S)
Roberto Primi
(R)
Angelo Auricchio
(A)
Giulio Conte
(G)
Pietro Rossi
(P)
Filippo Angelini
(F)
Arianna Morena
(A)
Antonio Toscano
(A)
Valeria Carinci
(V)
Giuseppe Dattilo
(G)
Nastasia Mancini
(N)
Marco Corda
(M)
Gianfranco Tola
(G)
Giulio Binaghi
(G)
Claudia Scudu
(C)
Lucy Barone
(L)
Alessandro Lupi
(A)
Claudia Carassia
(C)
Federica De Vecchi
(F)
Sara Vargiu
(S)
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.
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