GANGlion Stellate Block for Treatment of Electric storRm (GANGSTER Trial)

NCT ID: NCT05078684

Last Updated: 2021-10-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-21

Study Completion Date

2025-01-31

Brief Summary

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This study will evaluate the acute effect of ultrasound-navigated left ganglion stellate block to suppress ventricular arrhythmia in patients with arrhythmic storm.

Detailed Description

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* The study will include patients with drug-refractory arrhythmic storm indicated for left ganglion stellate block (LGSB) before or after catheter ablation.
* Included participants will be dived based on the need for mechanical ventilation and catheter ablation performed \<5 days before the study
* Subsequently, the participants will be randomized to LGSB or to a sham (placebo) procedure.
* The primary endpoint will be a reduction of the burden of clinical arrhythmia \>50% 24 hours after LGSB without escalation of antiarrhythmic therapy.
* The study will include 80 patients over 4 years.

Conditions

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Ventricular Arrythmia Ventricular Tachycardia Ventricular Fibrillation Arrhythmic Storm Block

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization 1:1 for active treatment vs. sham procedure
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
Patients, attending staff, and outcome assessors will not know whether the patient received the actual LGSB or a sham (placebo) procedure. The sham procedure will consist of subcutaneous application of a small amount (1ml) of the local anesthetic drug to the region of expected LGSB procedure.

Study Groups

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Actual LGSB

The patients will receive an actual LGSB procedure:

Using ultrasound navigation and an echo-contrast needle, 8ml of bupivacain (5%) will be applied to the site of the left ganglion stellate through an anterolateral approach in the neck region.

Group Type ACTIVE_COMPARATOR

Left ganglion stellate block

Intervention Type PROCEDURE

Ultrasound-guided anesthetic block of left ganglion stellate using 8ml of 5% bupivacaine.

Sham procedure

The procedure will be performed using the same instruments and anesthetic drug as the actual LGSB. However, the operator will apply only 0.5-1ml of the anesthetic drug and only subcutaneously to the site where an actual LGSB would be performed.

Group Type SHAM_COMPARATOR

Sham left ganglion stellate block

Intervention Type PROCEDURE

Subcutaneous application of 0.5-1ml of 5% bupivacaine to the site of expected LGSB

Interventions

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Left ganglion stellate block

Ultrasound-guided anesthetic block of left ganglion stellate using 8ml of 5% bupivacaine.

Intervention Type PROCEDURE

Sham left ganglion stellate block

Subcutaneous application of 0.5-1ml of 5% bupivacaine to the site of expected LGSB

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. arrhythmic storm \<24 hours before inclusion:

* 3 or more episodes of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) terminated by external or internal shock,
* or incessant VT lasting \>30 minutes,
* or very frequent nonsustained or sustained VT leading to hemodynamic instability with the need of escalation of the therapy
2. clinical indication for LBGS based on the judgment of the physician, independent of the study

Exclusion Criteria

1. known allergy to bupivacaine
2. prior LBGS performed \<7 days before the study
3. known reversible provoking trigger of the arrhythmias
4. ventricular arrhythmias triggered by premature ectopic beats during bradycardia
5. hemodynamically tolerated idiopathic VT in patients without structural heart disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute for Clinical and Experimental Medicine

OTHER_GOV

Sponsor Role lead

Responsible Party

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Marek Sramko, MD, PhD

Head of the Department of Acute Cardiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Institute for Clinical and Experimental Medicine (IKEM)

Prague, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Marek Sramko, MD, PhD

Role: CONTACT

+420776246127

Facility Contacts

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Marek Sramko, MD, PhD

Role: primary

+420731682681

Other Identifiers

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A-21-25

Identifier Type: -

Identifier Source: org_study_id