Arrhythmias & electrophysiologyCohort study
Impact of single vs. dual local anaesthetic regimen on the efficacy and safety of percutaneous stellate ganglion block for electrical storm: new insights from the STAR study
- multicentre STAR registry
- propensity score matching
- multivariable analysis
Authors' conclusion
The combination of two local anaesthetics for PSGB is significantly associated with a greater likelihood of early and complete ventricular arrhythmia suppression in patients with electrical storm. Despite the need for randomized ad hoc trials, the dual-LA regimen represents an optimization strategy for PSGB, offering enhanced efficacy without an increased risk of major complications.
Study context
- Population
- Patients with refractory electrical storm (ES) treated with percutaneous stellate ganglion block (PSGB)patients, 422 PSGB procedures
- Participants
- 298 patients
- Exposure
- single vs. dual LA regimen
- dual local anaesthetics (LAs)n = 70%
- single LAn = 30%
Main finding
As reported in the abstract
- Both regimens significantly reduced the number of treated ventricular arrhythmias
Observational data: associations, not effects.
Further findings
Complete VA suppression · 1 h · significantly higher with dual LAs
P < 0.01
Complete VA suppression · 3 h · significantly higher with dual LAs
P = 0.02
- Complete VA suppression: confirmed after propensity score matching and multivariable analysis
Safety
Total complication rate (driven by minor ones) · higher with two LAs
P = 0.02
- Total complication rate (driven by minor ones): no longer significant after adjusting for the procedural approach (lateral vs. anterior)
Original publication
Summarised from the published abstract; every number is checked against it