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Sympathetic Innervation Of The Anterior Left Ventricular Wall By The Right And Left Stellate Ganglia.
MedLine Citation:
PMID:  22465457     Owner:  NLM     Status:  Publisher    
BACKGROUND: The sympathetic nervous system is thought to play a role in the genesis of ventricular tachyarrhythmias (VT). Left and added right cardiac sympathectomy have been shown to reduce burden of arrhythmias in the setting of VT storm. However, the contribution of the right and left stellate ganglia to the innervation of the left ventricular (LV) anterior wall is not well understood. OBJECTIVE: The purpose of this study was to evaluate the innervation of the anterior LV by the left (LSG) and right stellate ganglia (RSG). METHODS: The heart and stellate ganglia were exposed via sternotomy in pigs with normal hearts (n=8). A 20-electrode catheter was placed on the anterior LV wall to record activation recovery interval (ARI), a surrogate measure of action potential duration. A microdialysis catheter was inserted in a similar location to sample interstitial norepinephrine (NE) content. ARI and NE measurements were recorded at baseline and during LSG and RSG stimulation. RESULTS: LSG stimulation shortened ARI by 17.1±10.5% (mean ±SE) while RSG stimulation shortened ARI by 42.1±15.7%, p=0.04 (LSG vs. RSG). LSG stimulation increased interstitial NE levels by 200±65%, while RSG increased NE content by 260±40%, p=0.012. LSG stimulation increased dispersion in ARI from 376.0±83.7 ms(2) to 1242.5±566 ms(2), p=0.03 and caused VF in 2 pigs. During RSG stimulation, dispersion increased from 419±65.8ms(2) to 474.8±81 ms(2), p=0.4. CONCLUSIONS: Both the LSG and RSG provide significant innervation to the anterior LV as demonstrated by both ARI shortening and NE concentrations. LSG stimulation significantly increases ARI dispersion. This study provides mechanistic insight into the beneficial effects of left sympathectomy and the additional role of right sympathectomy in reducing arrhythmias in patients with anterior myocardial scars and VT storm.
Marmar Vaseghi; Wei Zhou; James Shi; Olujimi Ajijola; Joseph Hadaya; Kalyanam Shivkumar; Aman Mahajan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-26
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-4-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
UCLA Cardiac Arrhythmia Center, Los Angeles, CA; Cardiac Autonomics Group, Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, Los Angeles, CA.
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