Stellate Ganglion Phototherapy Using Low-Level Laser: A Novel Rescue Therapy for Patients With Refractory Ventricular Arrhythmias.

Autor:	Nonoguchi NM; Department of Cardiovascular Medicine, Kyorin University Hospital, Mitaka, Japan., Adachi M; Department of Cardiology, Sanin Rosai Hospital, Yonago, Japan., Nogami A; Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan., Komatsu Y; Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Cardiovascular Medicine, Yokohama Rosai Hospital, Yokohama, Japan., Sato T; Division of Advanced Arrhythmia Management, Kyorin University School of Medicine, Mitaka, Japan., Ueda A; Division of Advanced Arrhythmia Management, Kyorin University School of Medicine, Mitaka, Japan., Ogawa K; Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan., Togashi I; Division of Advanced Arrhythmia Management, Kyorin University School of Medicine, Mitaka, Japan., Miwa Y; Department of Cardiovascular Medicine, Kyorin University Hospital, Mitaka, Japan., Hoshida K; Department of Cardiovascular Medicine, Kyorin University Hospital, Mitaka, Japan., Momose Y; Department of Cardiovascular Medicine, Kyorin University Hospital, Mitaka, Japan., Shinoda Y; Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan., Kowase S; Department of Cardiovascular Medicine, Yokohama Rosai Hospital, Yokohama, Japan., Nakamura K; Department of Cardiology, Toho University Ohashi Medical Center, Tokyo, Japan., Kaneko S; Department of Cardiology, Toyota Kosei Hospital, Toyota, Japan., Soejima K; Department of Cardiovascular Medicine, Kyorin University Hospital, Mitaka, Japan. Electronic address: skyoko@ks.kyorin-u.ac.jp.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2021 Oct; Vol. 7 (10), pp. 1297-1308. Date of Electronic Publication: 2021 Jun 30.
DOI:	10.1016/j.jacep.2021.04.015
Abstrakt:	Objectives: This study investigates the effect of stellate ganglion (SG) phototherapy in healthy participants and assesses its efficacy in suppressing electrical storm (ES) refractory to antiarrhythmic drugs and catheter ablation. Background: Modulation of the autonomic nervous system has been shown to be an effective adjunctive therapy for ES. Methods: Ten-minute SG phototherapy was performed twice weekly for 4 weeks in 20 healthy volunteers. To evaluate the acute and chronic effects of SG phototherapy, heart rate variability and serum concentrations of adrenaline, noradrenaline, and dopamine were obtained before phototherapy, immediately after the first phototherapy session, after 8 sessions of phototherapy, and 3 months after the first phototherapy session. In addition, the efficacy of SG phototherapy was evaluated in 11 patients with ES refractory to medication, sedation, and catheter ablation. Results: In healthy participants, serum adrenaline concentration significantly decreased after phototherapy, whereas low-frequency power/high-frequency power significantly decreased during phototherapy. Moreover, the effect on heart rate variability did not last beyond 3 months. In the clinical pilot study, 7 patients had a suppression of ES after SG phototherapy; however, without maintenance therapy, 2 patients had a recurrence of ventricular arrhythmias. Furthermore, it did not control ES in 4 patients. Conclusions: SG phototherapy reduced sympathetic activity and may be a safe and effective adjunctive therapy to control ES in some patients, but its long-term efficacy remains unknown. Chronic phototherapy might help reduce ES recurrence. Competing Interests: Funding Support and Author Disclosures Dr Soejima has received honoraria for lectures from Abbott Japan and Medtronic Japan. Dr Nogami has received honoraria from Abbott Japan and Boston Scientific; and endowments from Medtronic Japan and Johnson & Johnson. Drs Ueda and Sato have endowments from Biotronik Japan and Abbott Japan. Dr Togashi has endowments from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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