Renal denervation decreases effective refractory period but not inducibility of ventricular fibrillation in a healthy porcine biomodel: a case control study

. 2015 Jan 16 ; 13 () : 4. [epub] 20150116

Jazyk angličtina Země Velká Británie, Anglie Médium electronic

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid25591755

BACKGROUND: Ventricular arrhythmias play an important role in cardiovascular mortality especially in patients with impaired cardiac and autonomic function. The aim of this experimental study was to determine, if renal denervation (RDN) could decrease the inducibility of ventricular fibrillation (VF) in a healthy porcine biomodel. METHODS: Controlled electrophysiological study was performed in 6 biomodels 40 days after RDN (RDN group) and in 6 healthy animals (control group). The inducibility of VF was tested by programmed ventricular stimulation from the apex of right ventricle (8 basal stimuli coupled with up to 4 extrastimuli) always three times in each biomodel using peripheral extracorporeal oxygenation for hemodynamic support. Further, basal heart rate (HR), PQ and QT intervals and effective refractory period of ventricles (ERP) were measured. Technical success of RDN was evaluated by histological examination. RESULTS: According to histological findings, RDN procedure was successfully performed in all biomodels. Comparing the groups, basal HR was lower in RDN group: 79 (IQR 58; 88) vs. 93 (72; 95) beats per minute (p = 0.003); PQ interval was longer in RDN group: 145 (133; 153) vs. 115 (113; 120) ms (p < 0.0001) and QTc intervals were comparable: 402 (382; 422) ms in RDN vs. 386 (356; 437) ms in control group (p = 0.1). ERP was prolonged significantly in RDN group: 159 (150; 169) vs. 140 (133; 150) ms (p = 0.001), but VF inducibility was the same (18/18 vs. 18/18 attempts). CONCLUSIONS: RDN decreased the influence of sympathetic nerve system on the heart conduction system in healthy porcine biomodel. However, the electrophysiological study was not associated with a decrease of VF inducibility after RDN.

Zobrazit více v PubMed

Lombardi F, Verrier RL, Lown B. Relationship between sympathetic neural activity and vulnerability to ventricular-fibrillation (Vf) during myocardial ischemia and reperfusion. Circulation. 1981;64:318. PubMed

Lown B, Verrier RL. Neural activity and ventricular-fibrillation. N Engl J Med. 1976;294:1165–1170. doi: 10.1056/NEJM197603182941201. PubMed DOI

Schwartz PJ. The autonomic nervous system and sudden death. Eur Heart J. 1998;19(Suppl F):F72–F80. PubMed

La Rovere MT, Bigger JT, Jr, Marcus FI, Mortara A, Schwartz PJ. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet. 1998;351:478–484. doi: 10.1016/S0140-6736(97)11144-8. PubMed DOI

Nolan J, Batin PD, Andrews R, Lindsay SJ, Brooksby P, Mullen M, Baig W, Flapan AD, Cowley A, Prescott RJ, Neilson JM, Fox KA. Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart) Circulation. 1998;98:1510–1516. doi: 10.1161/01.CIR.98.15.1510. PubMed DOI

Lamaida N, Capuano V, Dimauro G, Aucello G, Diquacquaro GS. Possible role of beta-blockers in the prevention of sudden cardiac death (Scd) in patients with coronary heart-disease (Chd) Panminerva Med. 1994;36:71–75. PubMed

Hjalmarson A. Prevention of sudden cardiac death with beta blockers. Clin Cardiol. 1999;22:V11–V15. doi: 10.1002/clc.4960221504. PubMed DOI

Olde Nordkamp LR, Driessen AH, Odero A, Blom NA, Koolbergen DR, Schwartz PJ, Wilde AA. Left cardiac sympathetic denervation in the Netherlands for the treatment of inherited arrhythmia syndromes. Neth Heart J. 2014;22:160–166. doi: 10.1007/s12471-014-0523-2. PubMed DOI PMC

Hage FG, Aggarwal H, Patel K, Chen J, Jacobson AF, Heo J, Ahmed A, Iskandrian AE. The relationship of left ventricular mechanical dyssynchrony and cardiac sympathetic denervation to potential sudden cardiac death events in systolic heart failure. J Nucl Cardiol. 2014;21:78–85. doi: 10.1007/s12350-013-9807-y. PubMed DOI

Mahfoud F, Luscher TF, Andersson B, Baumgartner I, Cifkova R, Dimario C, Doevendans P, Fagard R, Fajadet J, Komajda M, Lefèvre T, Lotan C, Sievert H, Volpe M, Widimsky P, Wijns W, Williams B, Windecker S, Witkowski A, Zeller T, Böhm M, European Society of Cardiology Expert consensus document from the European Society of Cardiology on catheter-based renal denervation. Eur Heart J. 2013;34:2149–2157. doi: 10.1093/eurheartj/eht154. PubMed DOI

Krum H, Schlaich M, Whitbourn R, Sobotka PA, Sadowski J, Bartus K, Kapelak B, Walton A, Sievert H, Thambar S, Abraham WT, Esler M. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet. 2009;373:1275–1281. doi: 10.1016/S0140-6736(09)60566-3. PubMed DOI

Symplicity HTNI, Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, Bohm M. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376:1903–1909. doi: 10.1016/S0140-6736(10)62039-9. PubMed DOI

Hering D, Lambert EA, Marusic P, Walton AS, Krum H, Lambert GW, Esler MD, Schlaich MP. Substantial reduction in single sympathetic nerve firing after renal denervation in patients with resistant hypertension. Hypertension. 2013;61:457–464. doi: 10.1161/HYPERTENSIONAHA.111.00194. PubMed DOI

Ukena C, Mahfoud F, Spies A, Kindermann I, Linz D, Cremers B, Laufs U, Neuberger HR, Bohm M. Effects of renal sympathetic denervation on heart rate and atrioventricular conduction in patients with resistant hypertension. Int J Cardiol. 2013;167:2846–2851. doi: 10.1016/j.ijcard.2012.07.027. PubMed DOI

Linz D, Mahfoud F, Schotten U, Ukena C, Hohl M, Neuberger HR, Wirth K, Bohm M. Renal sympathetic denervation provides ventricular rate control but does not prevent atrial electrical remodeling during atrial fibrillation. Hypertension. 2013;61:225–231. doi: 10.1161/HYPERTENSIONAHA.111.00182. PubMed DOI

Hou Y, Hu J, Po SS, Wang H, Zhang L, Zhang F, Wang K, Zhou Q. Catheter-based renal sympathetic denervation significantly inhibits atrial fibrillation induced by electrical stimulation of the left stellate ganglion and rapid atrial pacing. PLoS One. 2013;8:e78218. doi: 10.1371/journal.pone.0078218. PubMed DOI PMC

Pokushalov E, Romanov A, Corbucci G, Artyomenko S, Baranova V, Turov A, Shirokova N, Karaskov A, Mittal S, Steinberg JS. A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension. J Am Coll Cardiol. 2012;60:1163–1170. doi: 10.1016/j.jacc.2012.05.036. PubMed DOI

Linz D, Wirth K, Ukena C, Mahfoud F, Poss J, Linz B, Bohm M, Neuberger HR. Renal denervation suppresses ventricular arrhythmias during acute ventricular ischemia in pigs. Heart Rhythm. 2013;10:1525–1530. doi: 10.1016/j.hrthm.2013.07.015. PubMed DOI

Ukena C, Bauer A, Mahfoud F, Schreieck J, Neuberger HR, Eick C, Sobotka PA, Gawaz M, Bohm M. Renal sympathetic denervation for treatment of electrical storm: first-in-man experience. Clin Res Cardiol. 2012;101:63–67. doi: 10.1007/s00392-011-0365-5. PubMed DOI

Hoffmann BA, Steven D, Willems S, Sydow K. Renal sympathetic denervation as an adjunct to catheter ablation for the treatment of ventricular electrical storm in the setting of acute myocardial infarction. J Cardiovasc Electrophysiol. 2013;24(12):E21. doi: 10.1111/jce.12282. PubMed DOI

McGlone JJ, Swanson J. Update on the guide for the care and use of agricultural animals in research and teaching. J Dairy Sci. 2010;93:12. doi: 10.3168/jds.2009-2244. PubMed DOI

Schwartz PJ, Verrier RL, Lown B. Effect of stellectomy and vagotomy on ventricular refractoriness in dogs. Circ Res. 1977;40:536–540. doi: 10.1161/01.RES.40.6.536. PubMed DOI

Schwartz PJ, Snebold NG, Brown AM. Effects of unilateral cardiac sympathetic denervation on the ventricular fibrillation threshold. Am J Cardiol. 1976;37:1034–1040. doi: 10.1016/0002-9149(76)90420-3. PubMed DOI

Ng GA, Brack KE, Patel VH, Coote JH. Autonomic modulation of electrical restitution, alternans and ventricular fibrillation initiation in the isolated heart. Cardiovasc Res. 2007;73:750–760. doi: 10.1016/j.cardiores.2006.12.001. PubMed DOI

Vanoli E, Schwartz PJ. Sympathetic–parasympathetic interaction and sudden death. Basic Res Cardiol. 1990;85(Suppl 1):305–321. PubMed

Bourke T, Vaseghi M, Michowitz Y, Sankhla V, Shah M, Swapna N, Boyle NG, Mahajan A, Narasimhan C, Lokhandwala Y, Shivkumar K. Neuraxial modulation for refractory ventricular arrhythmias: value of thoracic epidural anesthesia and surgical left cardiac sympathetic denervation. Circulation. 2010;121:2255–2262. doi: 10.1161/CIRCULATIONAHA.109.929703. PubMed DOI PMC

Belohlavek J, Mlcek M, Huptych M, Svoboda T, Havranek S, Ost’adal P, Bouček T, Kovárník T, Mlejnský F, Mrázek V, Bělohlávek M, Aschermann M, Linhart A, Kittnar O. Coronary versus carotid blood flow and coronary perfusion pressure in a pig model of prolonged cardiac arrest treated by different modes of venoarterial ECMO and intraaortic balloon counterpulsation. Crit Care. 2012;16:R50. doi: 10.1186/cc11254. PubMed DOI PMC

Havranek S, Belohlavek J, Mlcek M, Huptych M, Boucek T, Svoboda T, Fichtl J, Hrachovina M, Linhart A, Kittnar O. Median frequencies of prolonged ventricular fibrillation treated by V-A ECMO correspond to a return of spontaneous circulation rate. Int J Artif Organs. 2014;1:48–57. doi: 10.5301/ijao.5000291. PubMed DOI

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...