Effects of stepwise denervation of the stellate ganglion: Novel insights from an acute canine study

Gang Wu, Christopher V. DeSimone, Scott H. Suddendorf, Roshini S. Asirvatham, Samuel J Asirvatham, Congxin Huang, Peng Sheng Chen, Yong-Mei Cha

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The stellate ganglion (SG) is important for cardiac autonomic control. SG modification is an option for treating refractory ventricular tachyarrhythmias. The optimal extent of left- and right-sided SG denervation necessary for antiarrhythmic effect, however, remains to be learned. Objective: The purpose of this study was to evaluate the effects of stepwise SG denervation on hemodynamic and electrophysiological parameters in dogs. Methods: After sequential left and right thoracotomy in 8 healthy dogs, the SG was exposed by dissection. Two pacing wires were placed in the upper SG to deliver high-frequency stimulation. The lower SG, ansae subclaviae, and upper SG were removed in a stepwise manner. The same protocol was performed on the right side. Blood pressure (BP), heart rate, and electrophysiological parameters were recorded at baseline and after 5 minutes of stimulation. Results: Systolic and diastolic BP significantly increased during stimulation of the upper left SG. The mean increase in systolic BP from baseline was 49.4 ± 26.6 mm Hg (P = .007), 25.5 ± 14.1 mm Hg after the lower SG was removed (P = .02), and 8.6 ± 3.4 mm Hg after resection of the ipsilateral ansae subclaviae (P = .048). Heart rate and other electrophysiological parameters did not change significantly. After the complete removal of the left SG, systolic BP increased by 34.0 ± 17.6 mm Hg (P = .005) after stimulation of the right SG. Conclusion: Sympathetic output remains after the lower SG is removed, and sympathetic output from the right SG remains after the complete resection of the left SG and ansae subclaviae. Thus, some patients who undergo left SG denervation can still have significant sympathetic response via right SG regulation.

Original languageEnglish (US)
JournalHeart Rhythm
DOIs
StateAccepted/In press - 2016

Fingerprint

Stellate Ganglion
Denervation
Canidae
Blood Pressure
Heart Rate
Dogs

Keywords

  • Ansa subclavia
  • Canine
  • Cardiac sympathetic denervation
  • Stellate ganglion
  • Vagal trunk

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Effects of stepwise denervation of the stellate ganglion : Novel insights from an acute canine study. / Wu, Gang; DeSimone, Christopher V.; Suddendorf, Scott H.; Asirvatham, Roshini S.; Asirvatham, Samuel J; Huang, Congxin; Chen, Peng Sheng; Cha, Yong-Mei.

In: Heart Rhythm, 2016.

Research output: Contribution to journalArticle

Wu, Gang ; DeSimone, Christopher V. ; Suddendorf, Scott H. ; Asirvatham, Roshini S. ; Asirvatham, Samuel J ; Huang, Congxin ; Chen, Peng Sheng ; Cha, Yong-Mei. / Effects of stepwise denervation of the stellate ganglion : Novel insights from an acute canine study. In: Heart Rhythm. 2016.
@article{5d4f74a861bc42048b99329d5df8a59c,
title = "Effects of stepwise denervation of the stellate ganglion: Novel insights from an acute canine study",
abstract = "Background: The stellate ganglion (SG) is important for cardiac autonomic control. SG modification is an option for treating refractory ventricular tachyarrhythmias. The optimal extent of left- and right-sided SG denervation necessary for antiarrhythmic effect, however, remains to be learned. Objective: The purpose of this study was to evaluate the effects of stepwise SG denervation on hemodynamic and electrophysiological parameters in dogs. Methods: After sequential left and right thoracotomy in 8 healthy dogs, the SG was exposed by dissection. Two pacing wires were placed in the upper SG to deliver high-frequency stimulation. The lower SG, ansae subclaviae, and upper SG were removed in a stepwise manner. The same protocol was performed on the right side. Blood pressure (BP), heart rate, and electrophysiological parameters were recorded at baseline and after 5 minutes of stimulation. Results: Systolic and diastolic BP significantly increased during stimulation of the upper left SG. The mean increase in systolic BP from baseline was 49.4 ± 26.6 mm Hg (P = .007), 25.5 ± 14.1 mm Hg after the lower SG was removed (P = .02), and 8.6 ± 3.4 mm Hg after resection of the ipsilateral ansae subclaviae (P = .048). Heart rate and other electrophysiological parameters did not change significantly. After the complete removal of the left SG, systolic BP increased by 34.0 ± 17.6 mm Hg (P = .005) after stimulation of the right SG. Conclusion: Sympathetic output remains after the lower SG is removed, and sympathetic output from the right SG remains after the complete resection of the left SG and ansae subclaviae. Thus, some patients who undergo left SG denervation can still have significant sympathetic response via right SG regulation.",
keywords = "Ansa subclavia, Canine, Cardiac sympathetic denervation, Stellate ganglion, Vagal trunk",
author = "Gang Wu and DeSimone, {Christopher V.} and Suddendorf, {Scott H.} and Asirvatham, {Roshini S.} and Asirvatham, {Samuel J} and Congxin Huang and Chen, {Peng Sheng} and Yong-Mei Cha",
year = "2016",
doi = "10.1016/j.hrthm.2016.03.010",
language = "English (US)",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",

}

TY - JOUR

T1 - Effects of stepwise denervation of the stellate ganglion

T2 - Novel insights from an acute canine study

AU - Wu, Gang

AU - DeSimone, Christopher V.

AU - Suddendorf, Scott H.

AU - Asirvatham, Roshini S.

AU - Asirvatham, Samuel J

AU - Huang, Congxin

AU - Chen, Peng Sheng

AU - Cha, Yong-Mei

PY - 2016

Y1 - 2016

N2 - Background: The stellate ganglion (SG) is important for cardiac autonomic control. SG modification is an option for treating refractory ventricular tachyarrhythmias. The optimal extent of left- and right-sided SG denervation necessary for antiarrhythmic effect, however, remains to be learned. Objective: The purpose of this study was to evaluate the effects of stepwise SG denervation on hemodynamic and electrophysiological parameters in dogs. Methods: After sequential left and right thoracotomy in 8 healthy dogs, the SG was exposed by dissection. Two pacing wires were placed in the upper SG to deliver high-frequency stimulation. The lower SG, ansae subclaviae, and upper SG were removed in a stepwise manner. The same protocol was performed on the right side. Blood pressure (BP), heart rate, and electrophysiological parameters were recorded at baseline and after 5 minutes of stimulation. Results: Systolic and diastolic BP significantly increased during stimulation of the upper left SG. The mean increase in systolic BP from baseline was 49.4 ± 26.6 mm Hg (P = .007), 25.5 ± 14.1 mm Hg after the lower SG was removed (P = .02), and 8.6 ± 3.4 mm Hg after resection of the ipsilateral ansae subclaviae (P = .048). Heart rate and other electrophysiological parameters did not change significantly. After the complete removal of the left SG, systolic BP increased by 34.0 ± 17.6 mm Hg (P = .005) after stimulation of the right SG. Conclusion: Sympathetic output remains after the lower SG is removed, and sympathetic output from the right SG remains after the complete resection of the left SG and ansae subclaviae. Thus, some patients who undergo left SG denervation can still have significant sympathetic response via right SG regulation.

AB - Background: The stellate ganglion (SG) is important for cardiac autonomic control. SG modification is an option for treating refractory ventricular tachyarrhythmias. The optimal extent of left- and right-sided SG denervation necessary for antiarrhythmic effect, however, remains to be learned. Objective: The purpose of this study was to evaluate the effects of stepwise SG denervation on hemodynamic and electrophysiological parameters in dogs. Methods: After sequential left and right thoracotomy in 8 healthy dogs, the SG was exposed by dissection. Two pacing wires were placed in the upper SG to deliver high-frequency stimulation. The lower SG, ansae subclaviae, and upper SG were removed in a stepwise manner. The same protocol was performed on the right side. Blood pressure (BP), heart rate, and electrophysiological parameters were recorded at baseline and after 5 minutes of stimulation. Results: Systolic and diastolic BP significantly increased during stimulation of the upper left SG. The mean increase in systolic BP from baseline was 49.4 ± 26.6 mm Hg (P = .007), 25.5 ± 14.1 mm Hg after the lower SG was removed (P = .02), and 8.6 ± 3.4 mm Hg after resection of the ipsilateral ansae subclaviae (P = .048). Heart rate and other electrophysiological parameters did not change significantly. After the complete removal of the left SG, systolic BP increased by 34.0 ± 17.6 mm Hg (P = .005) after stimulation of the right SG. Conclusion: Sympathetic output remains after the lower SG is removed, and sympathetic output from the right SG remains after the complete resection of the left SG and ansae subclaviae. Thus, some patients who undergo left SG denervation can still have significant sympathetic response via right SG regulation.

KW - Ansa subclavia

KW - Canine

KW - Cardiac sympathetic denervation

KW - Stellate ganglion

KW - Vagal trunk

UR - http://www.scopus.com/inward/record.url?scp=84964596695&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964596695&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2016.03.010

DO - 10.1016/j.hrthm.2016.03.010

M3 - Article

C2 - 26961299

AN - SCOPUS:84964596695

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

ER -