A case of post-STEMI electrical storm with multiple ICD shocks refractory to antiarrhythmic medications, treated successfully with bilateral sympathetic ganglionectomy.

Electrical storm (ES) is a life-threatening condition that requires a stepwise management approach, including antiarrhythmics, anxiolytics/sedatives, antiadrenergic, and hemodynamic support. In 88% of refractory cases, cardiac sympathetic denervation has proven effective in reducing ventricular tachycardia (VT) burden and ICD shocks. We present a patient with late-presenting ST-elevation myocardial infarction (STEMI), new reduced left ventricular ejection fraction (LVEF), post coronary artery bypass graft (CABG), who experienced recurrent monomorphic VT despite amiodarone, lidocaine, and left stellate ganglion block, who was successfully treated with bilateral video-assist thoracoscopy sympathetic ganglionectomy.