Preoperative stellate ganglion block to reduce atrial fibrillation after coronary artery bypass grafting

Preoperative Stellate Ganglion Block Reduce the Incidence of Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: A Prospective, Randomized Controlled Pilot Trial

This will test whether giving a stellate ganglion nerve block before CABG can lower the chance of postoperative atrial fibrillation in adults having bypass surgery.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Xijing Hospital (Academic / other)
• Drugs / interventions: chemotherapy
• Locations: 1 site (Xi'an, Shaanxi)
• Trial ID: NCT07271615 on ClinicalTrials.gov

What this trial studies

This single-center interventional study at Xijing Hospital will give a preoperative stellate ganglion block to adults scheduled for coronary artery bypass grafting and track the occurrence of postoperative atrial fibrillation. The main goal is to determine whether the procedure is feasible and whether it changes the rate of atrial fibrillation after surgery. Eligible patients are adults able to consent who are undergoing elective CABG and do not have prior atrial fibrillation, severely reduced left ventricular function, or major valve disease. Patients will be monitored in the perioperative period for arrhythmias and standard postoperative outcomes to determine feasibility and preliminary effect size.

Who should consider this trial

Good fit: Adults over 18 scheduled for elective CABG who can give informed consent, have LVEF ≥35%, and no history of atrial fibrillation or significant valvular disease are ideal candidates.

Not a fit: Patients with prior atrial fibrillation, emergency CABG, concomitant cardiac procedures, LVEF <35%, severe valve disease, or poorly controlled hyperthyroidism are unlikely to benefit or are excluded.

Why it matters

Potential benefit: If successful, the approach could lower the incidence of postoperative atrial fibrillation and reduce related complications and length of stay after CABG.

How similar studies have performed: Small studies and case series of sympathetic blockade for perioperative or refractory arrhythmias have shown promise, but evidence specifically preventing post-CABG atrial fibrillation is limited.

Eligibility criteria

Inclusion Criteria:

* more than 18 years old
* undergoing CABG
* Provide informed consent

Exclusion Criteria:

* History of prior cardiac surgery or atrial fibrillation ablation;
* Emergency coronary artery bypass grafting (CABG);
* Concomitant cardiac procedures (e.g., congenital heart disease repair, left ventricular reconstruction, valve surgery, or aortic surgery);
* Critical preoperative status requiring mechanical or pharmacological support before CABG;
* Left ventricular ejection fraction (LVEF) \<35%;
* History of atrial fibrillation (defined as a supraventricular tachyarrhythmia characterized by rapid and irregular atrial electrical activity);
* Significant mitral valve disease (mitral valve area \<1.5 cm² or regurgitant jet area \<4 cm²), significant aortic valve disease (valve area \<1.5 cm² or regurgitant jet-to-left ventricular outflow tract ratio \>25%);
* Severe left atrial enlargement (left atrial anteroposterior diameter \>55 mm);
* Poorly controlled hyperthyroidism;
* Conditions requiring radiotherapy, chemotherapy, or long-term hormonal therapy;
* Patients with known clinical contraindications to stellate ganglion block (SGB).

Where this trial is running

Xi'an, Shaanxi

• Xijing Hospital — Xi'an, Shaanxi, China (Recruiting)

Study contacts

• Study coordinator: Chong Lei

Conditions Adult Patients Undergoing CABG