TY - JOUR
T1 - Denervation of the extrinsic cardiac sympathetic nervous system as a treatment modality for arrhythmia
AU - Witt, Chance M.
AU - Bolona, Luciana
AU - Kinney, Michelle O.
AU - Moir, Christopher
AU - Ackerman, Michael J.
AU - Kapa, Suraj
AU - Asirvatham, Samuel J.
AU - McLeod, Christopher J.
N1 - Publisher Copyright:
© 2016 The Author.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Denervation of the extrinsic cardiac sympathetic nervous system is a method of altering the autonomic tone experienced by the heart and vasculature. It has been studied and employed as a therapy for cardiac disease for decades. Currently, there is a high level of interest in using cardiac denervation for treatment of arrhythmias. This review describes the anatomy and physiology of the cardiac autonomic nervous system followed by a discussion of the mechanistic studies which provide a basis for the therapeutic use of sympathetic denervation. The clinical research supporting its use in human arrhythmias is then appraised, covering the standard indications, such as long QT syndrome, as well as future possibilities. Last, a detailed account of the methods for performing surgical cardiac denervation and percutaneous stellate ganglion anesthetic block is provided, including the complications of each procedure. An understanding of the anatomy and physiology of the cardiac autonomic nervous system along with the techniques of surgical denervation and percutaneous anesthetic block will allow the clinician to effectively discuss and implement these therapies.
AB - Denervation of the extrinsic cardiac sympathetic nervous system is a method of altering the autonomic tone experienced by the heart and vasculature. It has been studied and employed as a therapy for cardiac disease for decades. Currently, there is a high level of interest in using cardiac denervation for treatment of arrhythmias. This review describes the anatomy and physiology of the cardiac autonomic nervous system followed by a discussion of the mechanistic studies which provide a basis for the therapeutic use of sympathetic denervation. The clinical research supporting its use in human arrhythmias is then appraised, covering the standard indications, such as long QT syndrome, as well as future possibilities. Last, a detailed account of the methods for performing surgical cardiac denervation and percutaneous stellate ganglion anesthetic block is provided, including the complications of each procedure. An understanding of the anatomy and physiology of the cardiac autonomic nervous system along with the techniques of surgical denervation and percutaneous anesthetic block will allow the clinician to effectively discuss and implement these therapies.
KW - Arrhythmia
KW - Autonomic nervous system
KW - Cardiac sympathetic denervation
KW - Stellate ganglion block
KW - Ventricular tachycardia
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U2 - 10.1093/europace/eux011
DO - 10.1093/europace/eux011
M3 - Review article
C2 - 28340164
AN - SCOPUS:85026417220
SN - 1099-5129
VL - 19
SP - 1075
EP - 1083
JO - Europace
JF - Europace
IS - 7
ER -