title: Effects of Renal Artery Denervation on Ventricular Arrhythmias in a Postinfarct Model.
abstract: BACKGROUND
  The therapeutic potential of renal denervation (RDN) for arrhythmias has not been fully explored. Detailed mechanistic evaluation is in order. The objective of the present study was to determine the antiarrhythmic potential of RDN in a postinfarct animal model and to determine whether any benefits relate to RDN-induced reduction of sympathetic effectors on the myocardium.
  
  
  RESULTS
  Pigs implanted with single-chamber implantable cardioverter defibrillators to record ventricular arrhythmias (VAs) were subjected to percutaneous coronary occlusion to induce myocardial infarction. Two weeks later, a sham or real RDN treatment was performed bilaterally using the St Jude EnligHTN basket catheter. Parameters of ventricular remodeling and modulation of cardio-renal sympathetic axis were monitored for 3 weeks after myocardial infarction. Histological analysis of renal arteries yielded a mean neurofilament score of healthy nerves that was significantly lower in the real RDN group than in sham controls; damaged nerves were found only in the real RDN group. There was a 100% reduction in the rate of spontaneous VAs after real RDN and a 75% increase in the rate of spontaneous VAs after sham RDN (P=0.03). In the infarcted myocardium, presence of sympathetic nerves and tissue abundance of neuropeptide-Y, an indicator of sympathetic nerve activities, were significantly lower in the RDN group. Peak and mean sinus tachycardia rates were significantly reduced after RDN.
  
  
  CONCLUSIONS
  RDN in the infarcted pig model leads to reduction of postinfarction VAs and myocardial sympathetic effectors. This may form the basis for a potential therapeutic role of RDN in postinfarct VAs.
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Nicholas
authors.initials: N
authors.lastname: Jackson
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Sigfús
authors.initials: S
authors.lastname: Gizurarson
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Mohammed Ali
authors.initials: MA
authors.lastname: Azam
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Benjamin
authors.initials: B
authors.lastname: King
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Andrew
authors.initials: A
authors.lastname: Ramadeen
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Nima
authors.initials: N
authors.lastname: Zamiri
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Andreu
authors.initials: A
authors.lastname: Porta-Sánchez
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Abdul
authors.initials: A
authors.lastname: Al-Hesayen
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: John
authors.initials: J
authors.lastname: Graham
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Marjan
authors.initials: M
authors.lastname: Kusha
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Stéphane
authors.initials: S
authors.lastname: Massé
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Patrick F H
authors.initials: PF
authors.lastname: Lai
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: John
authors.initials: J
authors.lastname: Parker
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Rohan
authors.initials: R
authors.lastname: John
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Tim-Rasmus
authors.initials: TR
authors.lastname: Kiehl
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Govind Krishna Kumar
authors.initials: GK
authors.lastname: Nair
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.).
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
authors.affiliation: From the Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology (N.J., S.G., M.A.A., B.K., N.Z., A.P.-S., M.K., S.M., P.F.H.L., G.K.K.N., K.N.) and Department of Pathology (R.J., T.-R.K.), University Health Network, Toronto, Ontario, Canada; St Michael's Hospital, Toronto, Ontario, Canada (A.R., A.A.-H., J.G., P.D.); University of Newcastle, Australia (N.J.); and Mount Sinai Hospital, Toronto, Ontario, Canada (J.P.). kumar.nanthakumar@uhn.ca.
authors.forename: Kumaraswamy
authors.initials: K
authors.lastname: Nanthakumar
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006321:Heart / Q000294:innervation*; D006339:Heart Rate; D007668:Kidney / Q000098:blood supply*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D020932:Nerve Growth Factor / Q000378:metabolism; D009478:Neuropeptide Y / Q000378:metabolism; D012077:Renal Artery / Q000294:innervation*; D034421:Sus scrofa; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D009478:Neuropeptide Y; D020932:Nerve Growth Factor
keywords: cardiac arrhythmia; coronary occlusion; myocardial infarction; neuropeptide Y; renal sympathetic denervation