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AUGMENTATION OF CARDIAC SYMPATHETIC TONE BY LOW LEVEL STELLATE GANGLION STIMULATION IN HUMANS
A272 JACC March 17, 2015 Volume 65, Issue 10S
Arrhythmias and Clinical EP Augmentation of Cardiac Sympathetic Tone by Low Level Stellate Ganglion Stimulation in Humans Moderated Poster Contributions Arrhythmias and Clinical EP Moderated Poster Theater, Poster Hall B1 Saturday, March 14, 2015, 11:45 a.m.-11:55 a.m. Session Title: Controversies in Clinical Arrhythmias Abstract Category: 7. Arrhythmias and Clinical EP: Other Presentation Number: 1129M-17 Authors: Olujimi Ajijola, Kimberly Howard-Quijano, Jennifer Scovotti, Christine Lee, Marmar Vaseghi, Aman Mahajan, Kalyanam Shivkumar, UCLA Cardiac Arrhythmia Center, Los Angeles, CA, USA, Division of Anesthesiology, Univ of California, Los Angeles, CA, USA
Background: High-frequency stimulation of cardiac sympathetic nerves over the pulmonary artery elicits premature ventricular contractions (PVCs). Our aim was to study the effect of low level left stellate ganglion (LSG) stimulation (SGS) on PVCs, hemodynamic, and cardiac electrophysiological indices.
Methods: Patients undergoing PVC ablation were recruited for SGS if PVCs were infrequent despite all interventions. A stimulating electrode was placed next to the LSG under fluoroscopy and ultrasound; and SGS (5-15Hz, 5-20mA) was performed. We measured hemodynamic and ECG parameters (RR interval, QT/QTc, T-wave amplitude and width), and activation recovery intervals (ARIs) (surrogate for action potential duration) from a duodecapolar catheter in the RVOT. Results: Five patients underwent SGS (3 males, 45±20yrs). SGS increased mean arterial blood pressure (80±13% to 95±18%, p=0.003) and dP/dt max (1148±244mmHg/sec to 1645±493mmHg/sec, p=0.03) in all patients, and shortened mean ARI (baseline: 302±48ms) in all patients (5.5±1.9%, p < 0.025 for all) except one who showed a 2% mean increase (P <0.01). Dispersion of repolarization (DOR) increased by 87±6.7% in two patients and decreased by 22.5±3% in three, consistent with animal models. At the level of SGS performed, no significant changes were seen in ECG indices, or PVCs. Conclusion: Low level left SGS increases blood pressure and contractility; and predominantly shortens ARI in the RVOT. These observations demonstrate feasibility of SGS in humans.
Arrhythmias and Clinical EP Augmentation of Cardiac Sympathetic Tone by Low Level Stellate Ganglion Stimulation in Humans Moderated Poster Contributions Arrhythmias and Clinical EP Moderated Poster Theater, Poster Hall B1 Saturday, March 14, 2015, 11:45 a.m.-11:55 a.m. Session Title: Controversies in Clinical Arrhythmias Abstract Category: 7. Arrhythmias and Clinical EP: Other Presentation Number: 1129M-17 Authors: Olujimi Ajijola, Kimberly Howard-Quijano, Jennifer Scovotti, Christine Lee, Marmar Vaseghi, Aman Mahajan, Kalyanam Shivkumar, UCLA Cardiac Arrhythmia Center, Los Angeles, CA, USA, Division of Anesthesiology, Univ of California, Los Angeles, CA, USA
Background: High-frequency stimulation of cardiac sympathetic nerves over the pulmonary artery elicits premature ventricular contractions (PVCs). Our aim was to study the effect of low level left stellate ganglion (LSG) stimulation (SGS) on PVCs, hemodynamic, and cardiac electrophysiological indices.
Methods: Patients undergoing PVC ablation were recruited for SGS if PVCs were infrequent despite all interventions. A stimulating electrode was placed next to the LSG under fluoroscopy and ultrasound; and SGS (5-15Hz, 5-20mA) was performed. We measured hemodynamic and ECG parameters (RR interval, QT/QTc, T-wave amplitude and width), and activation recovery intervals (ARIs) (surrogate for action potential duration) from a duodecapolar catheter in the RVOT. Results: Five patients underwent SGS (3 males, 45±20yrs). SGS increased mean arterial blood pressure (80±13% to 95±18%, p=0.003) and dP/dt max (1148±244mmHg/sec to 1645±493mmHg/sec, p=0.03) in all patients, and shortened mean ARI (baseline: 302±48ms) in all patients (5.5±1.9%, p < 0.025 for all) except one who showed a 2% mean increase (P <0.01). Dispersion of repolarization (DOR) increased by 87±6.7% in two patients and decreased by 22.5±3% in three, consistent with animal models. At the level of SGS performed, no significant changes were seen in ECG indices, or PVCs. Conclusion: Low level left SGS increases blood pressure and contractility; and predominantly shortens ARI in the RVOT. These observations demonstrate feasibility of SGS in humans.