Right Stellate Ganglion Blockade as a Bridging Therapy Prior to Sympathectomy in a Hemodynamically Unstable Adolescent With Ventricular Storm Secondary to Congenital Long QT Syndrome

Ventricular electrical storm is a life-threatening emergency, especially in pediatric settings. The condition is largely mediated by heightened cardiac adrenergic tone and may be triggered by acquired conditions, while therapeutic options remain limited. We report the case of a 15-year-old male adolescent with profound functional impairment and congenital long QT syndrome admitted to a tertiary pediatric cardiology referral center in Southern Brazil for the treatment of aspiration pneumonia, who subsequently presented with refractory ventricular electrical storm during hospitalization. Despite optimized medical therapy in the intensive care unit, the patient became severely hemodynamically unstable and was deemed unsuitable for immediate definitive cardiac sympathectomy. A temporary autonomic modulation strategy using right stellate ganglion blockade was proposed. The intervention was successful in suppressing the electric storm, promoting hemodynamic stabilization, and serving as a bridging therapy until sympathectomy could be safely performed under more stable clinical conditions.