Background and An electrical storm (ES) is a clinical emergency with a paucity of established treatment options. Despite initial encouraging Aims 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 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 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%).
Electrical storm treatment by percutaneous stellate ganglion block: the STAR study / Savastano, Simone; Baldi, Enrico; Compagnoni, Sara; Rordorf, Roberto; Sanzo, Antonio; Gentile, Francesca Romana; Dusi, Veronica; Frea, Simone; Gravinese, Carol; Cauti, Filippo Maria; Iannopollo, Gianmarco; De Sensi, Francesco; Gandolfi, Edoardo; Frigerio, Laura; Crea, Pasquale; Zagari, Domenico; Casula, Matteo; Sangiorgi, Giuseppe; Persampieri, Simone; Dell'Era, Gabriele; Patti, Giuseppe; Colombo, Claudia; Mugnai, Giacomo; Notaristefano, Francesco; Barengo, Alberto; Falcetti, Roberta; Perego, Giovanni Battista; D'Angelo, Giuseppe; Tanese, Nikita; Currao, Alessia; Sgromo, Vito; De Ferrari, Gaetano Maria; Null, Null; Fasolino, Alessandro; Bendotti, Sara; Primi, Roberto; Auricchio, Angelo; Conte, Giulio; Rossi, Pietro; Angelini, Filippo; Morena, Arianna; Toscano, Antonio; Carinci, Valeria; Dattilo, Giuseppe; Mancini, Nastasia; Corda, Marco; Tola, Gianfranco; Binaghi, Giulio; Scudu, Claudia; Barone, Lucy; Lupi, Alessandro; Carassia, Claudia; De Vecchi, Federica; Vargiu, Sara. - In: EUROPEAN HEART JOURNAL. - ISSN 1522-9645. - 45:10(2024), pp. 823-833. [10.1093/eurheartj/ehae021]
Electrical storm treatment by percutaneous stellate ganglion block: the STAR study
Iannopollo, Gianmarco;
2024
Abstract
Background and An electrical storm (ES) is a clinical emergency with a paucity of established treatment options. Despite initial encouraging Aims 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 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 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%).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
