Acute Modulation of Left Ventricular Control by Selective Intracardiac Sympathetic Denervation
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Acute Modulation of Left Ventricular Control by Selective Intracardiac Sympathetic Denervation. / Kahle, Ann-Kathrin; Klatt, Niklas; Jungen, Christiane; Dietenberger, Aaron; Kuklik, Pawel; Münkler, Paula; Willems, Stephan; Nikolaev, Viacheslav; Pauza, Dainius H; Scherschel, Katharina; Meyer, Christian.
in: JACC-CLIN ELECTROPHY, Jahrgang 9, Nr. 3, 03.2023, S. 371-384.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Acute Modulation of Left Ventricular Control by Selective Intracardiac Sympathetic Denervation
AU - Kahle, Ann-Kathrin
AU - Klatt, Niklas
AU - Jungen, Christiane
AU - Dietenberger, Aaron
AU - Kuklik, Pawel
AU - Münkler, Paula
AU - Willems, Stephan
AU - Nikolaev, Viacheslav
AU - Pauza, Dainius H
AU - Scherschel, Katharina
AU - Meyer, Christian
N1 - Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2023/3
Y1 - 2023/3
N2 - BACKGROUND: The sympathetic nervous system plays an integral role in cardiac physiology. Nerve fibers innervating the left ventricle are amenable to transvenous catheter stimulation along the coronary sinus (CS).OBJECTIVES: The aim of the present study was to modulate left ventricular control by selective intracardiac sympathetic denervation.METHODS: First, the impact of epicardial CS ablation on cardiac electrophysiology was studied in a Langendorff model of decentralized murine hearts (n = 10 each, ablation and control groups). Second, the impact of transvenous, anatomically driven axotomy by catheter-based radiofrequency ablation via the CS was evaluated in healthy sheep (n = 8) before and during stellate ganglion stimulation.RESULTS: CS ablation prolonged epicardial ventricular refractory period without (41.8 ± 8.4 ms vs 53.0 ± 13.5 ms; P = 0.049) and with β1-2-adrenergic receptor blockade (47.8 ± 7.8 ms vs 73.1 ± 13.2 ms; P < 0.001) in mice. Supported by neuromorphological studies illustrating a circumferential CS neural network, intracardiac axotomy by catheter ablation via the CS in healthy sheep diminished the blood pressure increase during stellate ganglion stimulation (Δ systolic blood pressure 21.9 ± 10.9 mm Hg vs 10.5 ± 12.0 mm Hg; P = 0.023; Δ diastolic blood pressure 9.0 ± 5.5 mm Hg vs 3.0 ± 3.5 mm Hg; P = 0.039).CONCLUSIONS: Transvenous, anatomically driven axotomy targeting nerve fibers along the CS enables acute modulation of left ventricular control by selective intracardiac sympathetic denervation.
AB - BACKGROUND: The sympathetic nervous system plays an integral role in cardiac physiology. Nerve fibers innervating the left ventricle are amenable to transvenous catheter stimulation along the coronary sinus (CS).OBJECTIVES: The aim of the present study was to modulate left ventricular control by selective intracardiac sympathetic denervation.METHODS: First, the impact of epicardial CS ablation on cardiac electrophysiology was studied in a Langendorff model of decentralized murine hearts (n = 10 each, ablation and control groups). Second, the impact of transvenous, anatomically driven axotomy by catheter-based radiofrequency ablation via the CS was evaluated in healthy sheep (n = 8) before and during stellate ganglion stimulation.RESULTS: CS ablation prolonged epicardial ventricular refractory period without (41.8 ± 8.4 ms vs 53.0 ± 13.5 ms; P = 0.049) and with β1-2-adrenergic receptor blockade (47.8 ± 7.8 ms vs 73.1 ± 13.2 ms; P < 0.001) in mice. Supported by neuromorphological studies illustrating a circumferential CS neural network, intracardiac axotomy by catheter ablation via the CS in healthy sheep diminished the blood pressure increase during stellate ganglion stimulation (Δ systolic blood pressure 21.9 ± 10.9 mm Hg vs 10.5 ± 12.0 mm Hg; P = 0.023; Δ diastolic blood pressure 9.0 ± 5.5 mm Hg vs 3.0 ± 3.5 mm Hg; P = 0.039).CONCLUSIONS: Transvenous, anatomically driven axotomy targeting nerve fibers along the CS enables acute modulation of left ventricular control by selective intracardiac sympathetic denervation.
U2 - 10.1016/j.jacep.2022.10.013
DO - 10.1016/j.jacep.2022.10.013
M3 - SCORING: Journal article
C2 - 36752452
VL - 9
SP - 371
EP - 384
JO - JACC-CLIN ELECTROPHY
JF - JACC-CLIN ELECTROPHY
SN - 2405-500X
IS - 3
ER -