While preoperative right stellate ganglion block did not reduce the incidence of postoperative atrial fibrillation after valve surgery with cardiopulmonary bypass, it was associated with potential benefits, including less intraoperative defibrillation for ventricular arrhythmias, lower high-sensitivity troponin I, and decreased risk of postoperative acute kidney injury.
Preoperative ultrasound-guided right stellate ganglion block did not reduce the incidence of postoperative atrial fibrillation (POAF) after valve surgery with cardiopulmonary bypass.
SGB was associated with a lower incidence of intraoperative ventricular fibrillation/ventricular tachycardia requiring defibrillation after aortic cross-clamp release.
SGB was associated with lower postoperative high-sensitivity troponin I levels, indicating attenuated myocardial injury.
SGB was associated with a reduced risk of postoperative acute kidney injury.
The trial was a single-center, randomized, double-blind, placebo-controlled study of 140 patients undergoing valve surgery with cardiopulmonary bypass.
This study tested whether a nerve block given before heart valve surgery could prevent atrial fibrillation (an irregular heart rhythm that commonly occurs after cardiac surgery). Researchers randomly assigned 140 patients to receive an ultrasound-guided injection near the right stellate ganglion (a cluster of nerves in the neck that affects heart rhythm control) with either the numbing drug ropivacaine or a saltwater placebo. Neither patients nor staff assessing outcomes knew which was given. The nerve block did not lower the rate of atrial fibrillation: about 43% of the block group and 40% of the placebo group developed it within the first week or until discharge. However, the block group had fewer dangerous ventricular rhythm problems needing defibrillation during surgery after the aortic clamp was released (6% vs 19%), lower blood levels of troponin I (a marker of heart muscle injury), and less acute kidney injury after surgery (5% vs 18%). This research suggests that the nerve block may not be useful for preventing postoperative atrial fibrillation, but it may offer other protective effects that would need confirmation. The study was at a single center and relatively small, and the secondary findings had borderline statistical significance, so larger trials are needed before drawing firm conclusions.
Zhang J, Chen Y, Li N, Ai Z, Liang J, Chen Y, et al.. (2026). Efficacy of Stellate Ganglion Block for Preventing Postoperative Atrial Fibrillation After Cardiac Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.126.051373