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A Study of Stellate Ganglion Block for Prevention of Atrial Fibrillation

Phase 2
Recruiting
Conditions
Atrial Fibrillation
Interventions
Procedure: Stellate ganglion block
Drug: Placebo
Registration Number
NCT05357690
Lead Sponsor
Mayo Clinic
Brief Summary

The purpose of this study is to test if a nerve block procedure called a stellate ganglion block can help decrease the chance of atrial fibrillation after surgery. Atrial fibrillation is the abnormal, fast beating of the upper chambers of the heart. Stellate ganglion blockade has shown to decrease other types of abnormal heart rhythms as well as decrease the chance of atrial fibrillation.

Detailed Description

The investigator hypothesizes that stellate ganglion blockade with local anesthetic performed prior to cardiac surgery will reduce the incidence and duration of postoperative atrial fibrillation (POAF).

Specific Aim 1: Determine the incidence of POAF in patients receiving pre-surgical stellate ganglion blockade with local anesthetic versus saline placebo within one week of surgery or during hospitalization if discharged prior to one week.

Specific Aim 2: Determine the duration of POAF in patients receiving pre-surgical stellate ganglion blockade with local anesthetic versus saline placebo within one week of surgery or during hospitalization if discharged prior to one week.

Specific Aim 3: Determine the success rate of the block as evaluated by ipsilateral hand temperature change and skin sympathetic nerve activity (SKNA).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
220
Inclusion Criteria
  • Patient presenting for cardiac surgery at the Mayo Clinic in Rochester, Minnesota.
  • Patients scheduled to undergo mitral or aortic valve surgery with or without coronary artery bypass grafting.
Exclusion Criteria
  • Patients with a history of permanent atrial fibrillation, left or right ventricular assist device implantation or explantation.
  • Patients with procedures not requiring cardiopulmonary bypass.
  • Patients with procedures requiring deep hypothermic circulatory arrest.
  • Patients with active infection or sepsis.
  • Pre-operative immunosuppressive medication use (including steroid use).
  • Pre-operative anti-arrhythmic medication use (aside from beta-blockers).
  • Patients with Immunodeficiency syndrome.
  • Patients with known neurologic disorder.
  • Patients requiring left internal jugular central line placement.
  • Performance of Maze procedures or left atrial appendage ligation procedures will not exclude patients from potential enrollment as atrial fibrillation still occurs postoperatively while the scarring from the Maze procedure forms.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Stellate ganglion block with local anestheticStellate ganglion blockSubjects will receive a single injection of bupivacaine in a stellate ganglion block
Stellate ganglion block with saline placeboPlaceboSubjects will receive a single injection of saline in a stellate ganglion block
Stellate ganglion block with saline placeboStellate ganglion blockSubjects will receive a single injection of saline in a stellate ganglion block
Stellate ganglion block with local anestheticBupivacaineSubjects will receive a single injection of bupivacaine in a stellate ganglion block
Primary Outcome Measures
NameTimeMethod
Incidence of atrial fibrillationWithin one week of surgery or during hospitalization if discharged prior to one week

Percentage of subjects to experience postoperative atrial fibrillation (POAF)

Secondary Outcome Measures
NameTimeMethod
Duration of atrial fibrillationWithin one week of surgery or during hospitalization if discharged prior to one week

Duration of postoperative atrial fibrillation (POAF)

Skin Sympathetic Nerve Activity10-30 minute following performance of nerve block

Measurement of difference in skin sympathetic nerve activity following block

Trial Locations

Locations (1)

Mayo Clinic in Rochester

🇺🇸

Rochester, Minnesota, United States

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