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星状神经节冷冻消融对起搏诱导心力衰竭犬模型中皮下神经活动和房性快速性心律失常的影响。

Effects of Stellate Ganglion Cryoablation on Subcutaneous Nerve Activity and Atrial Tachyarrhythmias in a Canine Model of Pacing-Induced Heart Failure.

机构信息

Krannert Institute of Cardiology and the Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

Krannert Institute of Cardiology and the Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.

出版信息

JACC Clin Electrophysiol. 2018 May;4(5):686-695. doi: 10.1016/j.jacep.2018.02.003. Epub 2018 Mar 28.

Abstract

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.

摘要

目的

本研究旨在验证皮下神经活动(SCNA)是否能充分评估起搏诱导心力衰竭(HF)犬的心脏交感神经张力和星状神经节冷冻消融的效果。

背景

SCNA 的记录是一种评估犬类交感神经张力的新方法。HF 已知会增加交感神经张力和心房性心律失常。

方法

通过植入放射性遥测器,对 12 只起搏诱导 HF 犬的星状神经节神经活动(SGNA)、迷走神经活动和 SCNA 进行研究。其中,6 只犬(消融组)在快速心室起搏前进行双侧星状神经节冷冻消融;其余 6 只犬(对照组)仅进行快速心室起搏。在两组中,均比较了 SCNA 与 SGNA 以及心律失常的发生情况。

结果

在 HF 诱导前后,对照组的 6 只犬在 360 次识别的心房性心动过速发作前,SCNA 始终增加。在所有犬中,SCNA 与 SGNA 相关,平均相关系数为 0.64(95%置信区间:0.58 至 0.70)。双侧星状神经节冷冻消融可显著降低 SCNA 从 0.34±0.033 μV 至 0.25±0.028 μV(p=0.03),并消除所有心房性心动过速。

结论

SCNA 可用于评估起搏诱导 HF 犬的心脏交感神经张力。星状神经节冷冻消融可降低 SCNA 和心律失常易感性。

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