Recurrent Ventricular Tachycardia, or Electrical Storm, is a relatively common\ncause of mortality and morbidity after myocardial infarction. We present\na case in which left stellate ganglion blocks were performed under ultrasound\nguidance in order to alleviate recurrent ventricular tachycardia in a patient\nrequiring extracorpeal membrane oxygenation after myocardial infarction. A\nmedically complex 54-year-old male after two weeks removed from an acute\nST elevation myocardial infarction status post stenting and intra-aortic balloon\npump placement presented in the cardiovascular intensive care unit with\nrecurrent unstable ventricular tachycardia while on extracorporeal membrane\noxygenation and multiple vasoactive infusions. Our acute pain service was\nconsulted by the cardiac electrophysiology service to provide left stellate ganglion\nblocks in attempt to attenuate electrical storm. Multiple single shot left\nstellate ganglion blocks were performed on subsequent days with increasing\nlocal anesthetic concentrations and volumes successfully providing temporary\nrelief of electrical storm. A left stellate ganglion catheter was eventually\nplaced, and a continuous infusion of local anesthesia was started. The patient\nexperienced complete relief from unstable ventricular tachycardia and no\nfurther defibrillations were required. The catheter remained in place for 14\ndays allowing for extracorporeal membrane oxygenation decannulation\nwithout the return of electrical storm. We believe ultrasound guided left stellate\nganglion blocks to be a relatively safe means to provide temporary relief\nof recurrent ventricular tachycardia.
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