Let $G$ be the isometry group of a quasi-geodesic Gromov-hyperbolic space $X$. If $X$ is empty there's not much so say, so assume otherwise. Say that $B\subset G$ is bounded if $Bx$ is bounded for some/every $x\in X$. When $X$ is proper, this just means that $B$ has compact closure.
Let $W$ be the kernel of the $G$-action on the Gromov boundary $\partial X$.
From Gromov's classification, an isometric action on a Gromov-hyperbolic falls into exactly one of the following (a) bounded orbits (b) horocyclic: unbounded, a unique fixed point on the boundary, no loxodromic (c) axial: a fixed pair on the boundary and some loxodromic, no other finite orbit on the boundary (d) focal: a unique fixed point on the boundary, some loxodromic (e) general type two loxodromic with disjoint ends.
We apply this to the $W$-action. (d), (e) are excluded since not all points can be fixed. (c) (axial) is possible only if the boundary is reduced to a pair (b) (horocyclic) is possible only if the boundary is a singleton. (a) is possible.
A) If the $G$-action is axial and the boundary is a pair, the $G$-action is axial as well. Let $E$ be a $G$-orbit: it is a quasi-geodesic. Suppose by contradiction that $E$ is not cobounded in $G$. Then since the $G$-action on $E$ is cobounded, for some $C$ and all $n$ there exists $x_n$ with $d(x_n,x_0)\le n$ and $d(x_n,E)\ge n-C$. Using hyperbolicity, one can show that the sequence $(x_n)$ is not equivalent to any one representing one of the ends of $E$. So there's a third point on the boundary, contradiction. Then $E$ is cobounded. In this case, the kernel $W$ is $G$ or has index 2 in $G$ according to whether $G$ switches the two boundary points.
Hence, if the $W$-action is axial, we are in (A) as above.
If the $W$-action is horocyclic, there's a single boundary point. Hence the $G$-action is horocyclic as well.
Otherwise the $W$-action is bounded, so $W$ is indeed bounded.
A bounded subgroup $H$ need not act trivially on the boundary. However, this holds if the $G$-action is cobounded and $H$ is normal in $G$.
In summary, we have exactly one of the following:
- $W$ is bounded (and if $G$ acts coboundedly, it is the largest bounded normal subgroup)
- $G$ acts horocyclically, and $\partial X$ is a singleton (example: $X$ horodisc in hyperbolic plane) — in this case $G$ can't act coboundedly
- $G$ acts axially coboundedly on $X$ (so $X$ is quasi-isometric to $\mathbf{Z}$); $W$ has index 1 or 2 on $G$ according to whether $G$ fixes the two boundary points.