Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram

Anisiia Doytchinova, Jonathan L. Hassel, Yuan Yuan, Hongbo Lin, Dechun Yin, David Adams, Susan Straka, Keith Wright, Kimberly Smith, David Wagner, Changyu Shen, Vicenta Salanova, Chad Meshberger, Lan S. Chen, John C. Kincaid, Arthur C. Coffey, Gang Wu, Yan Li, Richard J. Kovacs, Thomas H. EverettRonald Victor, Yong-Mei Cha, Shien Fong Lin, Peng Sheng Chen

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background Sympathetic nerve activity is important to cardiac arrhythmogenesis. Objective The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. Methods We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. Results In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1–V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P <.001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P <.05) and shortening of QT interval (P <.001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. Conclusion SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.

Original languageEnglish (US)
Pages (from-to)25-33
Number of pages9
JournalHeart Rhythm
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Electrocardiography
Skin
Stellate Ganglion
Valsalva Maneuver
Lidocaine
Heart Diseases
Electrodes
Heart Rate
Water
Ventricular Tachycardia
Inpatients
Epilepsy
Healthy Volunteers
Thorax
Injections

Keywords

  • Cold water pressor test
  • Microneurography
  • Sympathetic nerve activity
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Doytchinova, A., Hassel, J. L., Yuan, Y., Lin, H., Yin, D., Adams, D., ... Chen, P. S. (2017). Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram. Heart Rhythm, 14(1), 25-33. https://doi.org/10.1016/j.hrthm.2016.09.019

Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram. / Doytchinova, Anisiia; Hassel, Jonathan L.; Yuan, Yuan; Lin, Hongbo; Yin, Dechun; Adams, David; Straka, Susan; Wright, Keith; Smith, Kimberly; Wagner, David; Shen, Changyu; Salanova, Vicenta; Meshberger, Chad; Chen, Lan S.; Kincaid, John C.; Coffey, Arthur C.; Wu, Gang; Li, Yan; Kovacs, Richard J.; Everett, Thomas H.; Victor, Ronald; Cha, Yong-Mei; Lin, Shien Fong; Chen, Peng Sheng.

In: Heart Rhythm, Vol. 14, No. 1, 01.01.2017, p. 25-33.

Research output: Contribution to journalArticle

Doytchinova, A, Hassel, JL, Yuan, Y, Lin, H, Yin, D, Adams, D, Straka, S, Wright, K, Smith, K, Wagner, D, Shen, C, Salanova, V, Meshberger, C, Chen, LS, Kincaid, JC, Coffey, AC, Wu, G, Li, Y, Kovacs, RJ, Everett, TH, Victor, R, Cha, Y-M, Lin, SF & Chen, PS 2017, 'Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram', Heart Rhythm, vol. 14, no. 1, pp. 25-33. https://doi.org/10.1016/j.hrthm.2016.09.019
Doytchinova, Anisiia ; Hassel, Jonathan L. ; Yuan, Yuan ; Lin, Hongbo ; Yin, Dechun ; Adams, David ; Straka, Susan ; Wright, Keith ; Smith, Kimberly ; Wagner, David ; Shen, Changyu ; Salanova, Vicenta ; Meshberger, Chad ; Chen, Lan S. ; Kincaid, John C. ; Coffey, Arthur C. ; Wu, Gang ; Li, Yan ; Kovacs, Richard J. ; Everett, Thomas H. ; Victor, Ronald ; Cha, Yong-Mei ; Lin, Shien Fong ; Chen, Peng Sheng. / Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram. In: Heart Rhythm. 2017 ; Vol. 14, No. 1. pp. 25-33.
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abstract = "Background Sympathetic nerve activity is important to cardiac arrhythmogenesis. Objective The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. Methods We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. Results In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1–V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P <.001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P <.05) and shortening of QT interval (P <.001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73{\%}) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. Conclusion SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.",
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AU - Hassel, Jonathan L.

AU - Yuan, Yuan

AU - Lin, Hongbo

AU - Yin, Dechun

AU - Adams, David

AU - Straka, Susan

AU - Wright, Keith

AU - Smith, Kimberly

AU - Wagner, David

AU - Shen, Changyu

AU - Salanova, Vicenta

AU - Meshberger, Chad

AU - Chen, Lan S.

AU - Kincaid, John C.

AU - Coffey, Arthur C.

AU - Wu, Gang

AU - Li, Yan

AU - Kovacs, Richard J.

AU - Everett, Thomas H.

AU - Victor, Ronald

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AU - Lin, Shien Fong

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N2 - Background Sympathetic nerve activity is important to cardiac arrhythmogenesis. Objective The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. Methods We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. Results In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1–V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P <.001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P <.05) and shortening of QT interval (P <.001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. Conclusion SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.

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KW - Cold water pressor test

KW - Microneurography

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KW - Ventricular tachycardia

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