Author + information
- Received July 27, 2016
- Revision received January 23, 2018
- Accepted February 8, 2018
- Published online May 21, 2018.
- Richard S. Shelton, MDa,
- Masahiro Ogawa, MD, PhDa,b,
- Hongbo Lin, MSc,
- Changyu Shen, PhDc,
- Johnson Wong, BSa,
- Shien-Fong Lin, PhDd,
- Peng-Sheng Chen, MDa and
- Thomas H. Everett IV, PhDa,∗ ()
- aKrannert Institute of Cardiology and the Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
- bDepartment of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan
- cDivision of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
- dInstitute of Biomedical Engineering, National Chiao Tung University, Hsin-Chu, Taiwan
- ↵∗Address for correspondence:
Dr. Thomas H. Everett IV, Krannert Institute of Cardiology, Indiana University School of Medicine, 1800 North Capitol Avenue, Indianapolis, Indiana 46202.
Objectives This study aimed to test the hypothesis that subcutaneous nerve activity (SCNA) can adequately estimate the cardiac sympathetic tone and the effects of cryoablation of the stellate ganglion in dogs with pacing-induced heart failure (HF).
Background Recording of SCNA is a new method to estimate sympathetic tone in dogs. HF is known to increase sympathetic tone and atrial arrhythmias.
Methods Twelve dogs with pacing-induced HF were studied using implanted radiotransmitters to record the stellate ganglia nerve activity (SGNA), vagal nerve activity, and SCNA. Of these, 6 dogs (ablation group) underwent bilateral stellate ganglia cryoablation before the rapid ventricular pacing; the remaining 6 dogs (control group) had rapid ventricular pacing only. In both groups, SCNA was compared with SGNA and the occurrence of arrhythmias.
Results SCNA invariably increased before the 360 identified atrial tachyarrhythmia episodes in the 6 control dogs before and after HF induction. SCNA and SGNA correlated in all dogs with an average correlation coefficient of 0.64 (95% confidence interval: 0.58 to 0.70). Cryoablation of bilateral stellate ganglia significantly reduced SCNA from 0.34 ± 0.033 μV to 0.25 ± 0.028 μV (p = 0.03) and eliminated all atrial tachyarrhythmias.
Conclusions SCNA can be used to estimate cardiac sympathetic tone in dogs with pacing-induced HF. Cryoablation of the stellate ganglia reduced SCNA and arrhythmia vulnerability.
This study was supported in part by National Institutes of Health Grants P01HL78931, R01HL71140, R41HL124741, and R42DA043391, U18TR002208, and R01HL139829; a Medtronic-Zipes Endowment; the Charles Fisch Cardiovascular Research Award endowed by Dr. Suzanne B. Knoebel of the Krannert Institute of Cardiology; and the Indiana University Health-Indiana University School of Medicine Strategic Research Initiative. Drs. Lin, Wong, and Everett have equity interest in Arrhythmotech LLC., Cyberonics, and Medtronic; and St. Jude Medical Inc. donated research equipment to Dr. Chen’s research laboratory.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received July 27, 2016.
- Revision received January 23, 2018.
- Accepted February 8, 2018.
- 2018 American College of Cardiology Foundation