Renal sympathetic stimulation and ablation affect ventricular arrhythmia by modulating autonomic activity in a cesium-induced long QT canine model

Heart Rhythm. 2017 Jun;14(6):912-919. doi: 10.1016/j.hrthm.2017.02.010. Epub 2017 Feb 11.

Abstract

Background: Our previous studies showed that renal sympathetic stimulation (RS) may facilitate ischemic ventricular arrhythmia (VA) by increasing left stellate ganglion (LSG) nerve activity, whereas renal sympathetic ablation (RA) may suppress VA.

Objective: The purpose of this study was to investigate whether renal sympathetic interventions also can affect VA by modulating LSG activity in a cesium-induced long QT canine model.

Methods: Twenty-four dogs were randomly divided into RS group (n = 8), RA group (n = 8), or control group (n = 8). Serum norepinephrine, LSG function, and LSG neural activity were measured before and 3 hours after RS or RA. Increasing doses of cesium chloride then were administered until a "threshold dose" produced sustained ventricular tachycardia or ventricular fibrillation. Early afterdepolarization amplitude, VA prevalence, and tachycardia threshold dose were compared among these groups. Nerve growth factor and c-fos protein expressed in the LSG also were examined.

Results: Serum norepinephrine, LSG function, and LSG neural activity were all significantly increased after 3 hours of RS and all were decreased 3 hours after RA. In addition, RS significantly decreased the tachycardia threshold dose, increased the early afterdepolarization amplitude, facilitated the incidence of VAs, and increased the expression of nerve growth factor and c-fos protein. In contrast, RA induced the opposite effects.

Conclusion: RS promotes, whereas RA suppresses, the incidence of VAs in a canine model of cesium-induced long QT. Modulation of LSG neural activity by RS and RA may be responsible for these different effects.

Keywords: Left stellate ganglion; Long QT syndrome; Renal denervation; Renal sympathetic nerves; Sudden cardiac death.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autonomic Nervous System / physiopathology*
  • Autonomic Nervous System / surgery
  • Catheter Ablation / methods*
  • Cesium / toxicity
  • Disease Models, Animal
  • Dogs
  • Electric Stimulation Therapy / methods*
  • Electrocardiography*
  • Heart Rate / physiology*
  • Kidney / innervation*
  • Male
  • Stellate Ganglion / physiopathology
  • Sympathetic Nervous System / physiopathology
  • Sympathetic Nervous System / surgery
  • Tachycardia, Ventricular / chemically induced
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / therapy*

Substances

  • Cesium