Arrhythmias & electrophysiology
Safety and Efficacy of Ultrasound-Guided Sympathetic Blockade by Proximal Intercostal Block in Electrical Storm Patients
Authors' conclusion
In patients with refractory ES, continuous PICB provided safe and effective sympathetic block (77.8% ventricular arrhythmia suppression), achievable without interruption of anticoagulation, and without significant side effects.
Study context
- Population
- Patients with refractory electrical storm undergoing ultrasound-guided proximal intercostal block (PICB), January 2018–February 2023
- Participants
- 15 consecutive patients
- Exposure
- PICB alone vs stellate ganglion block (SGB) and PICB
- PICB alonen = 11
- SGB and PICBn = 4
- Outcome
- Procedural safety and short- and long-term outcomes (efficacy of PICB)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Excellent arrhythmia suppression
PICB alone
72.7%
- Excellent arrhythmia suppression with bilateral PICB
- 77.8%
- ICD therapies significantly reduced after PICB
- P < 0.05
- No ICD shock until discharge or heart transplant
- 93.3%
Observational data: associations, not effects.
Safety
Procedure-related complications
- No procedure-related complications; anticoagulation continued in all patients
Neurological and hemodynamic sequelae
- Mild transient neurological symptoms (patients)
- 3
- No significant neurological or hemodynamic sequelae
Original publication
Safety and Efficacy of Ultrasound-Guided Sympathetic Blockade by Proximal Intercostal Block in Electrical Storm Patients. JACC Clin Electrophysiol. Published 31 January 2024. doi:10.
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