Enrico Baldi, Roberto Rordorf, Sara Compagnoni, Veronica Dusi, Antonio Sanzo, Francesca Romana Gentile, Simone Frea, Carol Gravinese, Filippo Maria Cauti, Gianmarco Iannopollo, Francesco De Sensi, Edoardo Gandolfi, Laura Frigerio, Pasquale Crea, Domenico Zagari, Matteo Casula, Giuseppe Sangiorgi, Simone Persampieri, Gabriele Dell'Era, Giuseppe Patti, Claudia Colombo, Giacomo Mugnai, Francesco Notaristefano, Alberto Barengo, Roberta Falcetti, Giulia Girardengo, Giuseppe D'Angelo, Nikita Tanese, Alessia Currao, Vito Sgromo, Gaetano Maria De Ferrari, Simone Savastano
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引用次数: 0
摘要
背景：有关经皮星状神经节阻滞术（PSGB）在电风暴（ES）中疗效预测因素的数据很少：目的：评估经皮星状神经节阻滞（PSGB）疗效是否受术前心律失常类型和周期长度的影响：多中心 STAR 研究的子分析。方法：这是一项多中心 STAR 研究的子分析，根据 PSGB 术前最近一次室性心律失常的中位周期长度将人群分为三组：室颤（VF）、快速-VT 和慢速-VT。主要结果是PSGB后一小时内与PSGB前一小时相比，接受治疗的心律失常发作次数（使用ATP和/或DC冲击）：我们对 112 名患者的 139 次 PSGB 进行了研究，其中 51 次为 VF，44 次为快速 VT（VT 周期）：PSGB是治疗各种类型室性心律失常患者ES的有效方法。然而，PSGB对VF患者的疗效更为显著。
Efficacy of percutaneous stellate ganglion block according to ventricular arrhythmia cycle length: a post-hoc sub-analysis of the STAR study.
Background: Data on the predictors of percutaneous stellate ganglion block (PSGB) efficacy in electrical storm (ES) are scanty.
Objective: To assess whether the PSGB efficacy is influenced by the arrhythmia type and cycle length prior to the procedure.
Methods: A sub-analysis of the multicenter STAR study. The population was stratified into 3 groups according to the median cycle length of the latest ventricular arrhythmia before PSGB: ventricular fibrillation (VF), fast-VT and slow-VT. The primary outcome was the number of treated arrhythmic episodes (with ATPs and/or DC-shocks) in the hour immediately after PSGB compared to the hour before.
Results: We considered 139 PSGBs from 112 patients divided in 51 VF, 44 fast-VT (VT cycle<375 msec) and 44 slow-VT (VT cycle≥375 msec). The number of treated arrhythmic episodes in the hour after every PSGB was significantly lower compared to the hour before in all groups [VF:0 (IQR,0-1) vs 5 (IQR,2-8), p<0.001; fast-VT:0 (IQR,0-0) vs 1 (IQR,0-6.5), p<0.001; slow-VT:0 (IQR,0-0) vs 1 (IQR,0-4.5), p=0.001]. Analyzing the reduction of the number of ATPs/DC-shocks from the hour before to the hour after PSGB, a significant trend was observed across the groups (Jonckheere-Terpstra trend p<0.001) and a significant difference was observed comparing slow-VT vs VF and fast-VT versus VF, but not comparing slow-VT versus fast-VT. VF was independently associated with the probability of reduction of treated event after PSGB.
Conclusion: PSGB is an effective treatment for ES in patients with all type of ventricular arrhythmias. However, its effectiveness was more pronounced in patients with VF.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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