Key result
Targeted lung denervation attenuates respiratory sinus arrhythmia at 90 days.
Why the study?
Parasympathetic pulmonary nerve input contributes to respiratory sinus arrhythmia, and the impact of targeted lung denervation on RSA was unknown.
Does targeted lung denervation attenuate respiratory sinus arrhythmia in sheep and humans?
Does targeted lung denervation attenuate respiratory sinus arrhythmia in sheep and humans?
Targeted lung denervation attenuates respiratory sinus arrhythmia in both sheep and humans, indicating its potential utility as a procedural marker of successful denervation.
May indicate RSA attenuation as denervation marker; hypothesis-generating and should not yet change practice.
BACKGROUND: Targeted lung denervation (TLD) is a novel bronchoscopic therapy that disrupts parasympathetic pulmonary nerve input to the lung. Parasympathetic input to the heart originating from the lungs contributes to respiratory sinus arrhythmia (RSA) and disruption of pulmonary nerves via TLD may impact RSA. OBJECTIVE: The aim of this study was to assess the potential of TLD to affect RSA in sheep and humans. METHODS: TLD was performed in 5 sheep and 9 humans using a novel lung denervation system (Nu-vaira Inc., Minneapolis, MN, USA) with an electrocardiogram collected before and after the procedure. Frequency domain analysis of heart rate variability was performed in 5 sheep and 6 humans with presence of RSA approximated as high-frequency power (HF power). RESULTS: HF power decreased in 3 of 5 sheep with 1 animal reaching less than 7% of its baseline HF power 30 days after TLD. The average treatment location was more distal in the remaining 2 animals, which did not exhibit RSA attenuation, suggesting diminished denervation. HF power decreased in 5 of 6 humans, with 3 subjects reaching less than 50% of their baseline HF power 90 days after TLD. CONCLUSIONS: TLD appeared to attenuate RSA in both sheep and human cohorts of this sub-study. Further confirmation in humans is necessary to allow for RSA attenuation to be used as a marker of successful lung denervation via TLD.
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Valipour et al. (2019) studied this question. Targeted lung denervation (TLD) vs. Baseline (pre-procedure) was evaluated on High-frequency power (HF power) as an approximation of respiratory sinus arrhythmia. Targeted lung denervation attenuated respiratory sinus arrhythmia, with high-frequency power decreasing in 5 of 6 evaluated humans at 90 days post-procedure.
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