Wednesday, November 16, 2016

Q: 62 year old male with CHF is admitted to ICU with "V. Tach. storm". All measures to control his arrhythmia failed and cardiology service decided to do "Percutaneous Stellate Ganglion Block" (PSGB). At what level of spine it is usually done? 

A) C-2
B) C-5
C) T-1
D) T-8
E)  Trans-sternal


Answer: C

 Left "Percutaneous Stellate Ganglion Block" (PSGB) can be used as a last resort to suppress "V. Tach and V. Fib" in patients who are refractory to all measures including ablation. It is performed usually at the junction between the T1 vertebral body and the transverse process under fluoroscopy and digital subtraction angiography.



Reference: 

JUSTIN HAYASE, M.D., JIGAR PATEL, D.O.,SANJIV M. NARAYAN, M.D., Ph.D., F.A.C.C., F.H.R.S., DAVID E. KRUMMEN, M.D., F.A.C.C., F.H.R.S. - Percutaneous Stellate Ganglion Block Suppressing VT and VF in a Patient Refractory to VT Ablation - J Cardiovasc Electrophysiol. 2013 Aug; 24(8): 10.1111/jce.12138

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