Stellate Ganglion Phototherapy Using Low-Level Laser
Noriko Nonoguchi, Masamitsu Adachi, Akihiko Nogami, Yuki Komatsu, Toshiaki Sato, Akiko Ueda, Kojiro Ogawa, Ikuko Togashi, Yosuke Miwa, Kyoko Hoshida, Yuichi Momose, Yasutoshi Shinoda, Shinya Kowase, Keijiro Nakamura, Shinji Kaneko, Kyoko Soejima
Abstract
This study investigates the effect of stellate ganglion (SG) phototherapy in healthy participants and assesses its efficacy in suppressing electrical storm (ES) refractory to antiarrhythmic drugs and catheter ablation. Modulation of the autonomic nervous system has been shown to be an effective adjunctive therapy for ES. Ten-minute SG phototherapy was performed twice weekly for 4 weeks in 20 healthy volunteers. To evaluate the acute and chronic effects of SG phototherapy, heart rate variability and serum concentrations of adrenaline, noradrenaline, and dopamine were obtained before phototherapy, immediately after the first phototherapy session, after 8 sessions of phototherapy, and 3 months after the first phototherapy session. In addition, the efficacy of SG phototherapy was evaluated in 11 patients with ES refractory to medication, sedation, and catheter ablation. In healthy participants, serum adrenaline concentration significantly decreased after phototherapy, whereas low-frequency power/high-frequency power significantly decreased during phototherapy. Moreover, the effect on heart rate variability did not last beyond 3 months. In the clinical pilot study, 7 patients had a suppression of ES after SG phototherapy; however, without maintenance therapy, 2 patients had a recurrence of ventricular arrhythmias. Furthermore, it did not control ES in 4 patients. SG phototherapy reduced sympathetic activity and may be a safe and effective adjunctive therapy to control ES in some patients, but its long-term efficacy remains unknown. Chronic phototherapy might help reduce ES recurrence.