Advice Table 6 Open in new tab Sedation... | Oxford Academic

Advice Table 6

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Sedation and autonomic modulation

	Evidence	Strength
Advice TO DO
Initiate sympathetic blockade (esmolol, propranolol) in preference to lidocaine i.v. in ES patients with recent (<3 months) MI²⁶	RCT
The combination of i.v. amiodarone and oral propranolol is preferred to the combination of i.v. amiodarone and oral metoprolol in the management of ES in ICD patients¹⁴⁹	RCT
Initiate mild-to-moderate sedation (benzodiazepine) in all patients with an ES and ongoing/recurrent arrhythmia^140,141	OBS
May be appropriate TO DO
Deep sedation/general anaesthesia and mechanical ventilation may be appropriate in case of drug-refractory ES^140,141	OBS
Stellate ganglion block or TEA may be appropriate in SHD in the setting of ES or incessant VT/VF to reduce burden of VAs and ICD shocks as a bridge to more definitive therapy^{26,205–207,213}	OBS
Areas of uncertainty
The role of RDN as adjunct to ablation in patients with recurrent VAs and ES is uncertain	OBS

	Evidence	Strength
Advice TO DO
Initiate sympathetic blockade (esmolol, propranolol) in preference to lidocaine i.v. in ES patients with recent (<3 months) MI²⁶	RCT
The combination of i.v. amiodarone and oral propranolol is preferred to the combination of i.v. amiodarone and oral metoprolol in the management of ES in ICD patients¹⁴⁹	RCT
Initiate mild-to-moderate sedation (benzodiazepine) in all patients with an ES and ongoing/recurrent arrhythmia^140,141	OBS
May be appropriate TO DO
Deep sedation/general anaesthesia and mechanical ventilation may be appropriate in case of drug-refractory ES^140,141	OBS
Stellate ganglion block or TEA may be appropriate in SHD in the setting of ES or incessant VT/VF to reduce burden of VAs and ICD shocks as a bridge to more definitive therapy^{26,205–207,213}	OBS
Areas of uncertainty
The role of RDN as adjunct to ablation in patients with recurrent VAs and ES is uncertain	OBS

Advice Table 6

Open in new tab

Sedation and autonomic modulation

	Evidence	Strength
Advice TO DO
Initiate sympathetic blockade (esmolol, propranolol) in preference to lidocaine i.v. in ES patients with recent (<3 months) MI²⁶	RCT
The combination of i.v. amiodarone and oral propranolol is preferred to the combination of i.v. amiodarone and oral metoprolol in the management of ES in ICD patients¹⁴⁹	RCT
Initiate mild-to-moderate sedation (benzodiazepine) in all patients with an ES and ongoing/recurrent arrhythmia^140,141	OBS
May be appropriate TO DO
Deep sedation/general anaesthesia and mechanical ventilation may be appropriate in case of drug-refractory ES^140,141	OBS
Stellate ganglion block or TEA may be appropriate in SHD in the setting of ES or incessant VT/VF to reduce burden of VAs and ICD shocks as a bridge to more definitive therapy^{26,205–207,213}	OBS
Areas of uncertainty
The role of RDN as adjunct to ablation in patients with recurrent VAs and ES is uncertain	OBS

	Evidence	Strength
Advice TO DO
Initiate sympathetic blockade (esmolol, propranolol) in preference to lidocaine i.v. in ES patients with recent (<3 months) MI²⁶	RCT
The combination of i.v. amiodarone and oral propranolol is preferred to the combination of i.v. amiodarone and oral metoprolol in the management of ES in ICD patients¹⁴⁹	RCT
Initiate mild-to-moderate sedation (benzodiazepine) in all patients with an ES and ongoing/recurrent arrhythmia^140,141	OBS
May be appropriate TO DO
Deep sedation/general anaesthesia and mechanical ventilation may be appropriate in case of drug-refractory ES^140,141	OBS
Stellate ganglion block or TEA may be appropriate in SHD in the setting of ES or incessant VT/VF to reduce burden of VAs and ICD shocks as a bridge to more definitive therapy^{26,205–207,213}	OBS
Areas of uncertainty
The role of RDN as adjunct to ablation in patients with recurrent VAs and ES is uncertain	OBS