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Augmentation of cardiac sympathetic tone by percutaneous low‐level stellate ganglion stimulation in humans: a feasibility study
Author(s) -
Ajijola Olujimi A.,
HowardQuijano Kimberly,
Scovotti Jennifer,
Vaseghi Marmar,
Lee Christine,
Mahajan Aman,
Shivkumar Kalyanam
Publication year - 2015
Publication title -
physiological reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 39
ISSN - 2051-817X
DOI - 10.14814/phy2.12328
Subject(s) - medicine , stellate ganglion , cardiology , repolarization , hemodynamics , intracardiac injection , percutaneous , anesthesia , stimulation , blood pressure , heart rate , electrophysiology , alternative medicine , pathology
Modulation of human cardiac mechanical and electrophysiologic function by direct stellate ganglion stimulation has not been performed. Our aim was to assess the effect of low‐level left stellate ganglion ( LSG ) stimulation ( SGS ) on arrhythmias, hemodynamic, and cardiac electrophysiological indices. Patients undergoing ablation procedures for arrhythmias were recruited for SGS . A stimulating electrode was placed next to the LSG under fluoroscopy and ultrasound imaging; and SGS (5–10 Hz, 10–20 mA) was performed. We measured hemodynamic, intracardiac and ECG parameters, and activation recovery intervals ( ARI s) (surrogate for action potential duration) from a duodecapolar catheter in the right ventricular outflow tract. Five patients underwent SGS (3 males, 45 ± 20 years). Stimulating catheter placement was successful, and without complication in all patients. SGS did not change heart rate, but increased mean arterial blood pressure (78 ± 3 mmHg to 98 ± 5 mmHg, P  < 0.001) and dP /dt max (1148 ± 244 mmHg/sec to 1645 ± 493 mmHg/sec, P  = 0.03). SGS shortened mean ARI from 304 ± 23 msec to 283 ± 17 msec ( P  < 0.001), although one patient required parasympathetic blockade. Dispersion of repolarization ( DOR ) increased in four patients and decreased in one, consistent with animal models. QT interval, T‐wave duration and amplitude at baseline and with SGS were 415 ± 15 msec versus 399 ± 15 msec ( P  < 0.001); 201 ± 12 msec versus 230 ± 28 msec; and 0.2 ± 0.09 mV versus 0.22 ± 0.08 mV, respectively. At the level of SGS performed, no increase in arrhythmias was seen. Percutaneous low‐level SGS shortens ARI in the RVOT , and increases blood pressure and LV contractility. These observations demonstrate feasibility of percutaneous SGS in humans.

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