Left stellate ganglion and vagal nerve activity and cardiac arrhythmias in ambulatory dogs with pacing-induced congestive heart failure.
OBJECTIVE
The purpose of this study was to determine the patterns of autonomic nerve activity in congestive heart failure (CHF).


BACKGROUND
The relationship between autonomic nerve activity and cardiac arrhythmias in CHF is unclear.


METHODS
We implanted radiotransmitters in 6 dogs for continuous (24/7) simultaneous monitoring of left stellate ganglion nerve activity (SGNA), vagal nerve activity (VNA), and electrocardiography before and after pacing-induced CHF.


RESULTS
Congestive heart failure increased both SGNA and VNA. The SGNA but not VNA manifested a circadian variation pattern. There was extensive sinus node fibrosis. We analyzed 2,263 episodes of prolonged (>3 s) sinus pauses (PSP) and 1,420 long (>10 s) episodes of paroxysmal atrial tachycardia (PAT). Most (95.3%) PSP episodes occurred at night, and 56% were preceded by a short burst of SGNA that induced transient sinus tachycardia. Long PAT episodes were typically (83%) induced by simultaneous SGNA and VNA discharge, followed by VNA withdrawal. Premature ventricular contractions and ventricular tachycardia were preceded by elevated SGNA.


CONCLUSIONS
The reduction of sympathovagal balance at night in ambulatory dogs was due to reduced sympathetic discharge rather than a net increase of vagal discharge. The tachybrady syndrome in CHF might be triggered by an intermittent short burst of SGNA that resulted in tachycardia and sinus node suppression. Simultaneous sympathovagal discharge is a cause of long PAT episodes. These data indicate that there is an association between the specific patterns of autonomic nerve discharges and cardiac arrhythmia during CHF.
Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Masahiro
M
Ogawa
Shengmei
S
Zhou
Alex Y
AY
Tan
Juan
J
Song
Ghassan
G
Gholmieh
Michael C
MC
Fishbein
Huai
H
Luo
Robert J
RJ
Siegel
Hrayr S
HS
Karagueuzian
Lan S
LS
Chen
Shien-Fong
SF
Lin
Peng-Sheng
PS
Chen
D000818:Animals; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D004195:Disease Models, Animal; D004285:Dogs; D006325:Heart Atria / Q000473:pathology; D006333:Heart Failure / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D012849:Sinoatrial Node / Q000473:pathology; D013233:Stellate Ganglion / Q000502:physiology / Q000503:physiopathology*; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology; D014630:Vagus Nerve / Q000473:pathology / Q000502:physiology / Q000503:physiopathology*; D016276:Ventricular Function / Q000502:physiology; D018879:Ventricular Premature Complexes / Q000209:etiology / Q000503:physiopathology