Thai male 57 years, Risk HT . 1hr PTA had acute chest pain then developed VF arrest. Vital sign (after CPR ROSC) BP  114/72 mmHg HR 42 bpm. Heart irregular rhythm, fine crepitation both lungs. EKG showed ST elevation at II, III, aVF, ST depression at V1-V3 and High AV block. Echocardiogram showed LVEF 45%, HK at inferior wall, no significant valvular heart disease. Chest x-ray showed bilateral pulmonary congestion. STEMI fast tract was activated.  

EKG showed ST elevation at II, III, aVF, ST depression at V1-V3 and High AV block. Echocardiogram showed LVEF 45%, HK at inferior wall, no significant valvular heart disease. Chest x-ray showed bilateral pulmonary congestion. STEMI fast tract was activated.  

Coronary angiogram (CAG) via right femoral approach with JL 6/4 diagnostic catheter, JR 6/4 guiding catheter catheter showed normal Left main (LM), mild irregular, non significant stenosis left anterior descending artery LAD, LCx, complete blockage of proximal RCA.   

CAG showed normal Left main, mild irregular, non significant stenosis left anterior descending artery, LCx , complete blockage of proximal RCA.
PCI with JR 6/4 guiding catheter and wiring with Turntrac to RCA. Predilated with 2.0 x 15 mm Semi-compliant balloon upto 14 atm. Biolimus eluting stent deployed proximal RCA upto 10 atm, Balloon stent post dilated upto 14 atm. The final angiogram was acceptable result. Inserted temporary pacemaker via right femoral vein. After arrived CCU the patient developed cardiac arrest c VT storm. Left Stellate ganglion block was done during CPR and successful suppression of VT storm .     

1. Stellate ganglion block (SGB) is minimally invasive technique for treating electrical storm via temporary sympathetic interruption.2. SGB can effectively stabilizing VF storm in patients for whom other therapies have failed or to bridge them to advanced therapeautic interventions.3. SGB is a life-saving procedure. Even with no experience, you can try.