Document Detail


Spinal cord stimulation protects against atrial fibrillation induced by tachypacing.
MedLine Citation:
PMID:  22554859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spinal cord stimulation (SCS) has been shown to modulate atrial electrophysiology and confer protection against ischemia and ventricular arrhythmias in animal models.
OBJECTIVE: To determine whether SCS reduces the susceptibility to atrial fibrillation (AF) induced by tachypacing (TP).
METHODS: In 21 canines, upper thoracic SCS systems and custom cardiac pacing systems were implanted. Right atrial and left atrial effective refractory periods were measured at baseline and after 15 minutes of SCS. Following recovery in a subset of canines, pacemakers were turned on to induce AF by alternately delivering TP and searching for AF. Canines were randomized to no SCS therapy (CTL) or intermittent SCS therapy on the initiation of TP (EARLY) or after 8 weeks of TP (LATE). AF burden (percent AF relative to total sense time) and AF inducibility (percentage of TP periods resulting in AF) were monitored weekly. After 15 weeks, echocardiography and histology were performed.
RESULTS: Effective refractory periods increased by 21 ± 14 ms (P = .001) in the left atrium and 29 ± 12 ms (P = .002) in the right atrium after acute SCS. AF burden was reduced for 11 weeks in EARLY compared with CTL (P <.05) animals. AF inducibility remained lower by week 15 in EARLY compared with CTL animals (32% ± 10% vs 91% ± 6%; P <.05). AF burden and inducibility were not significantly different between LATE and CTL animals. There were no structural differences among any groups.
CONCLUSIONS: SCS prolonged atrial effective refractory periods and reduced AF burden and inducibility in a canine AF model induced by TP. These data suggest that SCS may represent a treatment option for AF.
Authors:
Scott A Bernstein; Brian Wong; Carolina Vasquez; Stuart P Rosenberg; Ryan Rooke; Laura M Kuznekoff; Joshua M Lader; Vanessa M Mahoney; Tatyana Budylin; Marie Älvstrand; Tammy Rakowski-Anderson; Rupinder Bharmi; Riddhi Shah; Steven Fowler; Douglas Holmes; Taraneh G Farazi; Larry A Chinitz; Gregory E Morley
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-01
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  9     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2013-01-29     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1426-33.e3     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York 10016, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Atrial Fibrillation / etiology,  pathology,  prevention & control*
Cardiac Pacing, Artificial / adverse effects*
Disease Models, Animal
Dogs
Electrocardiography
Heart Atria / innervation
Risk Assessment
Spinal Cord / physiology
Spinal Cord Stimulation / methods*
Time Factors
Grant Support
ID/Acronym/Agency:
HL076751/HL/NHLBI NIH HHS; R01 HL076751/HL/NHLBI NIH HHS; T32 HL098129/HL/NHLBI NIH HHS; T32HL098129/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Heart Rhythm. 2012 Sep;9(9):1434-5   [PMID:  22609159 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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