Stellate ganglion ablation by conventional radiofrequency in patients with electrical storm

We report a series of patients with Electrical Storm (ES) who underwent bilateral stellate ganglion ablation by using conventional radio frequency (RFA).

The procedure was done with fluoroscopic guidance using the COSMAN™ 1A RF Generator and a 22G RF needle (5 cm length and 5 mm active tip). Six patients, four male and two female (mean age 55 ± 7 years and mean LVEF—42 ± 21%) with ES underwent the procedure under fluoroscopic guidance. All patients experienced recurrent ICD shocks or required multiple external defibrillation shocks. There were no procedural complications. All patients survived free of ES at discharge. At a mean follow—up of 22 ± 8months, all were alive free of ES but two patients received appropriate shocks for VT and one patient had VT terminated by ATP.

This small series of cases is a proof of concept that neuromodulation by conventional RFA targeting bilateral stellate ganglia appears safe, feasible, and effective in treating selected unstable patients with ES.