Key result
Electrical stimulation of epicardial sympathetic nerves at the posterior basal site significantly shortened the ventricular fibrillation threshold to 11.5 V compared to 20.5 V in the control group.
Why the study?
Does electrical stimulation of epicardial sympathetic nerves at different sites induce varying degrees of cardiac electrical instability in dogs?
RCT (n=16)
Randomized
No
Does electrical stimulation of epicardial sympathetic nerves at different sites induce varying degrees of cardiac electrical instability in dogs?
Electrical stimulation of epicardial sympathetic nerves at the posterior basal site induces the most significant ventricular electrical instability, which correlates with local sympathetic nerve density.
Indicates site-specific sympathetic stimulation lowers VF threshold in canines; leaves open relevance to human ventricular arrhythmogenesis.
The cardiac sympathetic nerves distribute across cardiac tissues with uneven density. Yet, to what extent this anatomical heterogeneity affects electrical activity of the left ventricle is largely unknown. Dogs were randomized into non-stimulation control (NC), posterior basal-stimulation (PB), anterior superior-stimulation (AS), apical part-stimulation (AP) group. The epicardial sympathetic nerves at different sites along their distribution were with electrical stimulation (ES) for 4 hours except in the NC group. The myocardial effective refractory period (ERP), ventricular fibrillation threshold (VFT) and density of sympathetic nerves were recorded. Compared with ES at other places, the stimulation at PB site significantly shortened ERP (left ventricular anterior and posterior walls; PB group, 118 ± 4 ms, 106 ± 2 ms; Versus NC group, 155 ± 3.5 ms, 160 ± 3 ms; p < 0.01) and VFT (PB group, 11.5 ± 1.5 V; Versus NC group, 20.5 ± 0.9 V; p < 0.01), and induced remarkable regeneration of the cardiac sympathetic nerves, hence influencing electrical activity of the left ventricle to the most extent. Our study demonstrates that the degree of induced ventricular electrical instability is correlated tightly with the density of sympathetic nerves around ES site, and PB site is a potential target for modulating ventricular electrical activity to the maximal extent.
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Wang et al. (2018) conducted an RCT in Cardiac electrical instability (n=16). Electrical stimulation of epicardial sympathetic nerves at the posterior basal (PB) site vs. Non-stimulation control (NC) was evaluated on Ventricular fibrillation threshold (VFT) (p=<0.01). Electrical stimulation of epicardial sympathetic nerves at the posterior basal site significantly shortened the ventricular fibrillation threshold to 11.5 V compared to 20.5 V in the control group.
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