Doytchinova Anisiia, Patel Jheel, Zhou Shengmei, Chen Lan S, Lin Hongbo, Shen Changyu, Everett Thomas H, Lin Shien-Fong, Chen Peng-Sheng
Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, California.
Heart Rhythm. 2015 Mar;12(3):612-620. doi: 10.1016/j.hrthm.2014.11.007. Epub 2014 Nov 7.
Stellate ganglion nerve activity (SGNA) is important in ventricular arrhythmogenesis. However, because thoracotomy is needed to access the stellate ganglion, it is difficult to use SGNA for risk stratification.
The purpose of this study was to test the hypothesis that subcutaneous nerve activity (SCNA) in canines can be used to estimate SGNA and predict ventricular arrhythmia.
We implanted radiotransmitters to continuously monitor left stellate ganglion and subcutaneous electrical activities in 7 ambulatory dogs with myocardial infarction, complete heart block, and nerve growth factor infusion to the left stellate ganglion.
Spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) was documented in each dog. SCNA preceded a combined 61 episodes of VT and VF, 61 frequent bigeminy or couplets, and 61 premature ventricular contractions within 15 seconds in 70%, 59%, and 61% of arrhythmias, respectively. Similar incidence of 75%, 69%, and 62% was noted for SGNA. Progressive increase in SCNA [48.9 (95% confidence interval [CI] 39.3-58.5) vs 61.8 (95% CI 45.9-77.6) vs 75.1 (95% CI 57.5-92.7) mV-s] and SGNA [48.6 (95% CI 40.9-56.3) vs 58.5 (95% CI 47.5-69.4) vs 69.0 (95% CI 53.8-84.2) mV-s] integrated over 20-second intervals was demonstrated 60 seconds, 40 seconds, and 20 seconds before VT/VF (P <.05), respectively. The Pearson correlation coefficient for integrated SCNA and SGNA was 0.73 ± 0.18 (P <.0001 for all dogs, n = 5). Both SCNA and SGNA exhibited circadian variation.
SCNA can be used as an estimate of SGNA to predict susceptibility to VT and VF in a canine model of ventricular arrhythmia and sudden cardiac death.
星状神经节神经活动（SGNA）在室性心律失常的发生中起重要作用。然而，由于需要开胸才能接触到星状神经节，因此难以将SGNA用于风险分层。
本研究的目的是检验以下假设，即犬的皮下神经活动（SCNA）可用于估计SGNA并预测室性心律失常。
我们植入了无线电发射器，以连续监测7只患有心肌梗死、完全性心脏传导阻滞并向左侧星状神经节输注神经生长因子的活动犬的左侧星状神经节和皮下电活动。
每只犬均记录到自发性室性心动过速（VT）或室性颤动（VF）。在70%、59%和61%的心律失常中，SCNA分别在61次VT和VF合并发作、61次频发的二联律或三联律以及61次室性早搏前15秒出现。SGNA的发生率分别为75%、69%和62%，与之相似。在VT/VF前60秒、40秒和20秒，20秒间隔内的SCNA[48.9（95%置信区间[CI]39.3 - 58.5）对61.8（95%CI 45.9 - 77.6）对75.1（95%CI 57.5 - 92.7）mV - s]和SGNA[48.6（95%CI 40.9 - 56.3）对58.5（95%CI 47.5 - 69.4）对69.0（95%CI 53.8 - 84.2）mV - s]呈逐渐增加（P <.05）。整合后的SCNA和SGNA的Pearson相关系数为0.73±0.18（所有犬，n = 5，P <.0001）。SCNA和SGNA均表现出昼夜变化。
在室性心律失常和心源性猝死的犬模型中，SCNA可作为SGNA的一种估计指标，用于预测VT和VF的易感性。
