In a ventricular tachycardia (VT) storm, autonomic neuromodulation was beneficial. Transcutaneous magnetic stimulation (TcMS) could have influenced a patient’s nervous system activity noninvasively and nondestructively, potentially reducing VT load in patients with VT storms. For a study, the researchers sought to determine if TcMS of the left stellate ganglion was safe and effective for patients with VT storms. Between August 2019 and July 2021, a single tertiary referral hospital conducted a double-blind, sham-controlled randomized clinical trial. The research comprised 26 adult patients who had experienced t3 or more episodes of VT in the previous 24 hours. Patients were randomly allocated to either TcMS targeting the left stellate ganglion (n=14) or sham stimulation (n=12) for a single session. The primary outcome was the absence of VT during a 24-hour period after randomization. The burden of VT in the 72-hour period following randomization was a key secondary endpoint, as was the safety of TcMS on cardiac implantable electronic devices. A mean (SD) of 12.7 (10.3) bouts of VT occurred within the 24 hours preceding randomization among 26 patients (mean [SD] age, 64 [13] years; 20 [77%] male). Despite taking a mean (SD) of 2.0 (0.6) antiarrhythmic medications (AADs), patients had recurrent VT, and 11 patients (42%) needed mechanical hemodynamic support at the time of allocation. VT recurred in 4 of 14 TcMS patients (29% [SD 47%]) compared with 7 of 12 sham patients (58% [SD 51%]) in the 24-hour period after randomization (P=.20). The outcomes of the randomized clinical trial confirmed TcMS’s ability to safely lower the burden of VT in the setting of VT storm in patients with and without cardiac implantable electronic devices. They help shape future trials to investigate the unique therapy method further.
Link:jamanetwork.com/journals/jamacardiology/article-abstract/2788915
