• Erica D Wittwer, Misty A Radosevich, Matthew Ritter, and Yong-Mei Cha.
• Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, MN. Electronic address: Wittwer.erica@mayo.edu.
• J. Cardiothorac. Vasc. Anesth. 2020 Aug 1; 34 (8): 2245-2252.

AbstractRefractory ventricular arrhythmias (VAs) carry high mortality rates despite electrical and pharmacologic therapy utilization. These patients often require aggressive hemodynamic support, including mechanical circulatory devices such as extracorporeal membrane oxygenation because of progressive hemodynamic and metabolic deterioration. Sympathetic nervous system stimulation and neuronal remodeling after myocardial insults have been implicated as drivers of refractory VAs. This understanding has led to interest in and a growing body of experience with percutaneous blockade of the stellate ganglion as a means of interrupting the vicious cycle of refractory VAs. A number of techniques have been described for stellate ganglion blockade, including landmark-driven approaches, fluoroscopy-assisted blockade, and ultrasound guidance. Herein, the literature is evaluated and the authors' experience with stellate ganglion blockade using ultrasound guidance for refractory VAs is described.Copyright © 2019 Elsevier Inc. All rights reserved.

14 keywords...

hide…