Electrical storm treatment by percutaneous stellate ganglion block : the STAR study
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology..
BACKGROUND AND AIMS: 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: 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%).
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
European heart journal - 45(2024), 10 vom: 07. März, Seite 823-833 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Savastano, Simone [VerfasserIn] |
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| Links: |
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| Themen: |
Electrical storm |
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| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 19.03.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/eurheartj/ehae021 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
| 520 | |a BACKGROUND AND AIMS: 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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%) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Electrical storm | |
| 650 | 4 | |a Neuromodulation | |
| 650 | 4 | |a Stellate ganglion block | |
| 650 | 4 | |a Ventricular tachycardia | |
| 700 | 1 | |a Baldi, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Compagnoni, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Rordorf, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Sanzo, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Gentile, Francesca Romana |e verfasserin |4 aut | |
| 700 | 1 | |a Dusi, Veronica |e verfasserin |4 aut | |
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| 700 | 1 | |a Crea, Pasquale |e verfasserin |4 aut | |
| 700 | 1 | |a Zagari, Domenico |e verfasserin |4 aut | |
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| 700 | 1 | |a Persampieri, Simone |e verfasserin |4 aut | |
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| 700 | 1 | |a Patti, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Colombo, Claudia |e verfasserin |4 aut | |
| 700 | 1 | |a Mugnai, Giacomo |e verfasserin |4 aut | |
| 700 | 1 | |a Notaristefano, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Barengo, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Falcetti, Roberta |e verfasserin |4 aut | |
| 700 | 1 | |a Perego, Giovanni Battista |e verfasserin |4 aut | |
| 700 | 1 | |a D'Angelo, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Tanese, Nikita |e verfasserin |4 aut | |
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| 700 | 1 | |a Primi, Roberto |e investigator |4 oth | |
| 700 | 1 | |a Auricchio, Angelo |e investigator |4 oth | |
| 700 | 1 | |a Conte, Giulio |e investigator |4 oth | |
| 700 | 1 | |a Rossi, Pietro |e investigator |4 oth | |
| 700 | 1 | |a Angelini, Filippo |e investigator |4 oth | |
| 700 | 1 | |a Morena, Arianna |e investigator |4 oth | |
| 700 | 1 | |a Toscano, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Carinci, Valeria |e investigator |4 oth | |
| 700 | 1 | |a Dattilo, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Mancini, Nastasia |e investigator |4 oth | |
| 700 | 1 | |a Corda, Marco |e investigator |4 oth | |
| 700 | 1 | |a Tola, Gianfranco |e investigator |4 oth | |
| 700 | 1 | |a Binaghi, Giulio |e investigator |4 oth | |
| 700 | 1 | |a Scudu, Claudia |e investigator |4 oth | |
| 700 | 1 | |a Barone, Lucy |e investigator |4 oth | |
| 700 | 1 | |a Lupi, Alessandro |e investigator |4 oth | |
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| 700 | 1 | |a De Vecchi, Federica |e investigator |4 oth | |
| 700 | 1 | |a Vargiu, Sara |e investigator |4 oth | |
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