Effect of Renal Denervation on Suppression of PVC and QT Prolongation in a Porcine Model of Acute Myocardial Infarction

Abstract

Background and ObjectivesAntiarrhythmic effect of renal denervation (RDN) after acute myocardial infarction (AMI) remains unclear. The goal of this study was to evaluate the effect of RDN on ventricular arrhythmia (VA) after AMI in a porcine model.MethodsTwenty pigs were randomly divided into 2 groups based on RDN (RDN, n=10; Sham, n=10). After implanting a loop recorder, AMI was induced by occlusion of the middle left anterior descending coronary artery. Catheter-based RDN was performed for each renal artery immediately after creating AMI. Sham procedure used the same method, but a radiofrequency current was not delivered. Electrocardiography was monitored for 1 hour to observe VA. One week later, the animals were euthanized and the loop recorder data were analyzed.ResultsVentricular fibrillation event rate and the interval from AMI creation to first VA in acute phase were not different between the 2 groups. However, the incidence of premature ventricular complex (PVC) was lower in the RDN than in the Sham. Additionally, RDN inhibited prolongation of the corrected QT (QTc) interval after AMI. The frequency of non-sustained or sustained ventricular tachycardia, arrhythmic death was lower in the RDN group in the early period.ConclusionsRDN reduced the incidence of PVC, inhibited prolongation of the QTc interval, and reduced VA in the early period following an AMI. These results suggest that RDN might be a therapeutic option in patients with electrical instability after AMI.

Electroacupuncture Ameliorates Acute Myocardial Ischemic Injury and Long QT Interval in Mice through the α1A-Adrenergic Receptor: Electrophysiological, Morphological, and Molecular Evidence

“…Corrected QT (QTc) is generally used as an index to predict VA after MI [ 15 , 38 , 39 ]. In our study, it was observed that the QTc value of mice after MI was significantly longer than before, which was consistent with the previous studies [ 16 ]. Recent studies suggest that α 1A -AR activation reduces cardiac repolarization K + current, leading to acquired LQT [ 40 ], while the α 1 -AR blockers display antiarrhythmic effects in LQT2 animal models, thereby suggesting that α 1A -AR might prove to be an effective therapeutic target for acquired LQTS [ 41 ].…”

“…Corrected QT interval (QTc) based on the Bazett formula can be used as an important risk marker for patients at a higher risk of acute coronary syndrome [15]. Another study confirmed that the blockage of LAD in pigs induced AMI, which in turn prolonged the QTc interval [16]. This suggested that hERG might play a pivotal role in the pathogenesis of AMI injury and acquired LQTS.…”

An Open-label, Single-arm, Multicenter Feasibility Study Evaluating the Safety of Catheter-based Renal Denervation with DENEX™ in Patients with Uncontrolled Hypertension on Standard Medical Therapy

“…After success of recent trials, application of RDN beyond hypertension, such as arrhythmia, 17) heart failure, 18) or left ventricular remodeling are being investigated. With use of novel RDN systems, such as DENEX™ RDN, we anticipate RDN can expand its clinical utilization.…”

Renal Denervation, Come Back Time?

“…The promising of RDN therapy is not only for treatment of resistant hypertension, but also for some cardiovascular disease (CVD), like heart failure, chronic kidney disease and arrhythmias of which the increased sympathetic nervous activity contributes to the development and progression. 6) 7) 8) 9) 10) …”