Management of Rapid Atrial Fibrillation Using Stellate Ganglion Blockade.
Overview
abstract
BACKGROUND: Stellate ganglion blockade has been demonstrated as an efficacious treatment for refractory ventricular tachyarrhythmias. There are no published reports of the use of this technique in management of rapid atrial arrhythmia. CASE SUMMARY: A 73-year-old woman presented to our institution in rapid atrial fibrillation and cardiogenic shock. She was intubated for airway protection and underwent successful electrical cardioversion. However, atrial fibrillation returned multiple times with weaning of sedation for extubation. Stellate ganglion infusion catheter was placed with infusion of ropivacaine and subsequent maintenance of sinus rhythm, with successful extubation, ablation of atrial fibrillation, improvement of left ventricular ejection fraction, and discharge. TAKE-HOME MESSAGE: For selected patients, stellate ganglion blockade can be used as a technique to aid in the management of rapid atrial fibrillation.