title: Cryoablation of stellate ganglia and atrial arrhythmia in ambulatory dogs with pacing-induced heart failure.
abstract: BACKGROUND
  There is an association between autonomic nerve discharges and atrial arrhythmias (including bradycardia and tachycardia) in ambulatory dogs with pacing-induced heart failure (HF).
  
  
  OBJECTIVE
  The purpose of this study was to test the hypothesis that stellate ganglia ablation can reduce the incidence of atrial arrhythmias in a canine model of pacing-induced HF.
  
  
  METHODS
  Cryoablation of the caudal half of the left and right stellate ganglia and T2-T4 thoracic sympathetic ganglia was performed in six dogs (experimental group). Left upper stellate ganglia nerve activity, vagal nerve activity, and electrocardiogram were continuously recorded using an implanted radiotransmitter.
  
  
  RESULTS
  After 2 weeks of baseline recording, rapid right ventricular pacing (28 +/- 4 days) was used to induce HF. The control group (N = 6) underwent the same procedures except for cryoablation. The experimental group had no episodes of paroxysmal atrial tachycardia (P <.0001 vs control). Cryoablation significantly (P = .0097) reduced prolonged (>3 seconds) sinus pause episodes from 5 +/- 6 to 0 on day 1, from 250 +/- 424 to 11 +/- 11 on day 7, and from 123 +/- 206 to 30 +/- 33 on day 14 after induction of HF. In the experimental group only, vagal nerve activity may occur alone without concomitant stellate ganglia nerve activity. However, these isolated vagal nerve activity episodes did not result in prolonged sinus pause. Histologic studies confirmed successful cryoablation of the caudal half of the stellate ganglia.
  
  
  CONCLUSIONS
  Cryoablation of bilateral stellate and T2-T4 thoracic ganglia significantly reduced paroxysmal atrial tachycardia and prolonged sinus pause episodes induced by sympathetic discharges in dogs with pacing-induced HF.
authors: Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors: Masahiro
authors: M
authors: Ogawa
authors: Alex Y
authors: AY
authors: Tan
authors: Juan
authors: J
authors: Song
authors: Kenzaburo
authors: K
authors: Kobayashi
authors: Michael C
authors: MC
authors: Fishbein
authors: Shien-Fong
authors: SF
authors: Lin
authors: Lan S
authors: LS
authors: Chen
authors: Peng-Sheng
authors: PS
authors: Chen
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001281:Atrial Fibrillation / Q000601:surgery*; D001341:Autonomic Nervous System; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D003452:Cryosurgery; D004285:Dogs; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D015994:Incidence; D015999:Multivariate Analysis; D018570:Risk Assessment; D012804:Sick Sinus Syndrome; D013233:Stellate Ganglion / Q000601:surgery*; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*