Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation

Yuan Yuan, Xiao Liu, Juyi Wan, Johnson Wong, Amanda A. Bedwell, Scott A. Persohn, Changyu Shen, Michael C. Fishbein, L. S. Chen, Zhenhui Chen, Thomas Everett, Paul Territo, Peng-Sheng Chen

Research output: Contribution to journalArticle

Abstract

Background: Subcutaneous nerve stimulation (ScNS) damages the stellate ganglion and improves rhythm control of atrial fibrillation (AF) in ambulatory dogs. Objective: The purpose of this study was to test the hypothesis that thoracic ScNS can improve rate control in persistent AF. Methods: We created persistent AF in 13 dogs and randomly assigned them to ScNS (n = 6) and sham control (n = 7) groups. 18F-2-Fluoro-2-deoxyglucose positron emission tomography/magnetic resonance imaging of the brain stem was performed at baseline and at the end of the study. Results: The average stellate ganglion nerve activity reduced from 4.00 ± 1.68 μV after the induction of persistent AF to 1.72 ± 0.42 μV (P = .032) after ScNS. In contrast, the average stellate ganglion nerve activity increased from 3.01 ± 1.26 μV during AF to 5.52 ± 2.69 μV after sham stimulation (P = .023). The mean ventricular rate during persistent AF reduced from 149 ± 36 to 84 ± 16 beats/min (P = .011) in the ScNS group, but no changes were observed in the sham control group. The left ventricular ejection fraction remained unchanged in the ScNS group but reduced significantly in the sham control group. Immunostaining showed damaged ganglion cells in bilateral stellate ganglia and increased brain stem glial cell reaction in the ScNS group but not in the control group. The 18F-2-fluoro-2-deoxyglucose uptake in the pons and medulla was significantly (P = .011) higher in the ScNS group than the sham control group at the end of the study. Conclusion: Thoracic ScNS causes neural remodeling in the brain stem and stellate ganglia, controls the ventricular rate, and preserves the left ventricular ejection fraction in ambulatory dogs with persistent AF.

Original languageEnglish (US)
Pages (from-to)1383-1391
Number of pages9
JournalHeart Rhythm
Volume16
Issue number9
DOIs
StatePublished - Sep 1 2019

Fingerprint

Autonomic Nervous System
Stellate Ganglion
Positron-Emission Tomography
Atrial Fibrillation
Magnetic Resonance Imaging
Dogs
Thoracic Nerves
Brain Stem
Control Groups
Fluorodeoxyglucose F18
Stroke Volume
Pons
Neuroglia
Ganglia
Stem Cells

Keywords

  • Autonomic nervous system
  • Magnetic resonance imaging
  • Neuromodulation
  • Persistent atrial fibrillation
  • Positron emission tomography
  • Subcutaneous nerve stimulation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation. / Yuan, Yuan; Liu, Xiao; Wan, Juyi; Wong, Johnson; Bedwell, Amanda A.; Persohn, Scott A.; Shen, Changyu; Fishbein, Michael C.; Chen, L. S.; Chen, Zhenhui; Everett, Thomas; Territo, Paul; Chen, Peng-Sheng.

In: Heart Rhythm, Vol. 16, No. 9, 01.09.2019, p. 1383-1391.

Research output: Contribution to journalArticle

Yuan, Y, Liu, X, Wan, J, Wong, J, Bedwell, AA, Persohn, SA, Shen, C, Fishbein, MC, Chen, LS, Chen, Z, Everett, T, Territo, P & Chen, P-S 2019, 'Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation', Heart Rhythm, vol. 16, no. 9, pp. 1383-1391. https://doi.org/10.1016/j.hrthm.2019.05.029
Yuan, Yuan ; Liu, Xiao ; Wan, Juyi ; Wong, Johnson ; Bedwell, Amanda A. ; Persohn, Scott A. ; Shen, Changyu ; Fishbein, Michael C. ; Chen, L. S. ; Chen, Zhenhui ; Everett, Thomas ; Territo, Paul ; Chen, Peng-Sheng. / Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation. In: Heart Rhythm. 2019 ; Vol. 16, No. 9. pp. 1383-1391.
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abstract = "Background: Subcutaneous nerve stimulation (ScNS) damages the stellate ganglion and improves rhythm control of atrial fibrillation (AF) in ambulatory dogs. Objective: The purpose of this study was to test the hypothesis that thoracic ScNS can improve rate control in persistent AF. Methods: We created persistent AF in 13 dogs and randomly assigned them to ScNS (n = 6) and sham control (n = 7) groups. 18F-2-Fluoro-2-deoxyglucose positron emission tomography/magnetic resonance imaging of the brain stem was performed at baseline and at the end of the study. Results: The average stellate ganglion nerve activity reduced from 4.00 ± 1.68 μV after the induction of persistent AF to 1.72 ± 0.42 μV (P = .032) after ScNS. In contrast, the average stellate ganglion nerve activity increased from 3.01 ± 1.26 μV during AF to 5.52 ± 2.69 μV after sham stimulation (P = .023). The mean ventricular rate during persistent AF reduced from 149 ± 36 to 84 ± 16 beats/min (P = .011) in the ScNS group, but no changes were observed in the sham control group. The left ventricular ejection fraction remained unchanged in the ScNS group but reduced significantly in the sham control group. Immunostaining showed damaged ganglion cells in bilateral stellate ganglia and increased brain stem glial cell reaction in the ScNS group but not in the control group. The 18F-2-fluoro-2-deoxyglucose uptake in the pons and medulla was significantly (P = .011) higher in the ScNS group than the sham control group at the end of the study. Conclusion: Thoracic ScNS causes neural remodeling in the brain stem and stellate ganglia, controls the ventricular rate, and preserves the left ventricular ejection fraction in ambulatory dogs with persistent AF.",
keywords = "Autonomic nervous system, Magnetic resonance imaging, Neuromodulation, Persistent atrial fibrillation, Positron emission tomography, Subcutaneous nerve stimulation",
author = "Yuan Yuan and Xiao Liu and Juyi Wan and Johnson Wong and Bedwell, {Amanda A.} and Persohn, {Scott A.} and Changyu Shen and Fishbein, {Michael C.} and Chen, {L. S.} and Zhenhui Chen and Thomas Everett and Paul Territo and Peng-Sheng Chen",
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T1 - Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation

AU - Yuan, Yuan

AU - Liu, Xiao

AU - Wan, Juyi

AU - Wong, Johnson

AU - Bedwell, Amanda A.

AU - Persohn, Scott A.

AU - Shen, Changyu

AU - Fishbein, Michael C.

AU - Chen, L. S.

AU - Chen, Zhenhui

AU - Everett, Thomas

AU - Territo, Paul

AU - Chen, Peng-Sheng

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: Subcutaneous nerve stimulation (ScNS) damages the stellate ganglion and improves rhythm control of atrial fibrillation (AF) in ambulatory dogs. Objective: The purpose of this study was to test the hypothesis that thoracic ScNS can improve rate control in persistent AF. Methods: We created persistent AF in 13 dogs and randomly assigned them to ScNS (n = 6) and sham control (n = 7) groups. 18F-2-Fluoro-2-deoxyglucose positron emission tomography/magnetic resonance imaging of the brain stem was performed at baseline and at the end of the study. Results: The average stellate ganglion nerve activity reduced from 4.00 ± 1.68 μV after the induction of persistent AF to 1.72 ± 0.42 μV (P = .032) after ScNS. In contrast, the average stellate ganglion nerve activity increased from 3.01 ± 1.26 μV during AF to 5.52 ± 2.69 μV after sham stimulation (P = .023). The mean ventricular rate during persistent AF reduced from 149 ± 36 to 84 ± 16 beats/min (P = .011) in the ScNS group, but no changes were observed in the sham control group. The left ventricular ejection fraction remained unchanged in the ScNS group but reduced significantly in the sham control group. Immunostaining showed damaged ganglion cells in bilateral stellate ganglia and increased brain stem glial cell reaction in the ScNS group but not in the control group. The 18F-2-fluoro-2-deoxyglucose uptake in the pons and medulla was significantly (P = .011) higher in the ScNS group than the sham control group at the end of the study. Conclusion: Thoracic ScNS causes neural remodeling in the brain stem and stellate ganglia, controls the ventricular rate, and preserves the left ventricular ejection fraction in ambulatory dogs with persistent AF.

AB - Background: Subcutaneous nerve stimulation (ScNS) damages the stellate ganglion and improves rhythm control of atrial fibrillation (AF) in ambulatory dogs. Objective: The purpose of this study was to test the hypothesis that thoracic ScNS can improve rate control in persistent AF. Methods: We created persistent AF in 13 dogs and randomly assigned them to ScNS (n = 6) and sham control (n = 7) groups. 18F-2-Fluoro-2-deoxyglucose positron emission tomography/magnetic resonance imaging of the brain stem was performed at baseline and at the end of the study. Results: The average stellate ganglion nerve activity reduced from 4.00 ± 1.68 μV after the induction of persistent AF to 1.72 ± 0.42 μV (P = .032) after ScNS. In contrast, the average stellate ganglion nerve activity increased from 3.01 ± 1.26 μV during AF to 5.52 ± 2.69 μV after sham stimulation (P = .023). The mean ventricular rate during persistent AF reduced from 149 ± 36 to 84 ± 16 beats/min (P = .011) in the ScNS group, but no changes were observed in the sham control group. The left ventricular ejection fraction remained unchanged in the ScNS group but reduced significantly in the sham control group. Immunostaining showed damaged ganglion cells in bilateral stellate ganglia and increased brain stem glial cell reaction in the ScNS group but not in the control group. The 18F-2-fluoro-2-deoxyglucose uptake in the pons and medulla was significantly (P = .011) higher in the ScNS group than the sham control group at the end of the study. Conclusion: Thoracic ScNS causes neural remodeling in the brain stem and stellate ganglia, controls the ventricular rate, and preserves the left ventricular ejection fraction in ambulatory dogs with persistent AF.

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KW - Magnetic resonance imaging

KW - Neuromodulation

KW - Persistent atrial fibrillation

KW - Positron emission tomography

KW - Subcutaneous nerve stimulation

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