Renal denervation suppresses ventricular arrhythmias during acute ventricular ischemia in pigs

Linz, Dominik; Wirth, Klaus; Ukena, Christian; Mahfoud, Felix; Pöss, Janine; Linz, Benedikt; Böhm, Michael; Neuberger, Hans‐Ruprecht

doi:10.1016/j.hrthm.2013.07.015

Cited by 130 publications

(105 citation statements)

References 29 publications

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“…Similarly, Linz et al 6 demonstrated that RDN decreased episodes of VF during LAD occlusion and the number of PVCs during the first 10 minutes of ischemia, but not the occurrence of VF during reperfusion. They also demonstrated that the reduction in PVCs and VF during ischemia after RDN was similar to the reduction caused by atenolol administration.…”

Section: Effect Of Rdn On Spontaneous and Induced Vasmentioning

confidence: 86%

“…They also demonstrated that the reduction in PVCs and VF during ischemia after RDN was similar to the reduction caused by atenolol administration. 6 During the early stages of coronary occlusion, VAs occur predominantly because of reentry within the ischemic myocardium where depressed transmembrane potentials lead to slow conduction and block. 9 PVCs that initiate reentry may be reentrants themselves or may be because of triggered activity from Purkinje fibers in ischemic regions in response to increased catecholamine levels.…”

Section: Effect Of Rdn On Spontaneous and Induced Vasmentioning

confidence: 99%

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Effects of Renal Artery Denervation on Ventricular Arrhythmias in a Postinfarct Model

Jackson

Gizurarson

Azam

et al. 2017

Circ: Cardiovascular Interventions

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T he therapeutic potential of renal denervation (RDN) for cardiac arrhythmias was previously explored, yielding case reports and small case series that suggested RDN may be an effective adjunctive treatment in addition to medication and cardiac ablation for patients with ventricular tachycardia (VT) storm and atrial fibrillation.1-5 These promising results call for large-scale, well-controlled trials and detailed mechanistic evaluations. However, findings of the SYMPLICITY HTN-3 study (Renal Denervation in Patients With Uncontrolled Hypertension) have raised grave concerns over the benefits from RDN therapy for hypertension. 4 Hence, although RDN-based treatments are being developed for arrhythmias, it is important to reassess and confirm the antiarrhythmic potential of RDN in experiments designed to clearly demonstrate the impacts on cardiac electrophysiology. More importantly, the mechanistic basis of any antiarrhythmic effects should also be determined. See Editorial by Koruth and DukkipatiRDN has been shown to attenuate elevations in left ventricular end-diastolic pressure, suppress spontaneous premature beats, and reduce the incidence of ventricular fibrillation (VF) immediately post-acute coronary occlusion in pigs.6 RDN was also shown to reduce the incidence of ventricular arrhythmias (VAs) immediately after coronary occlusion in a similar acute canine model, in which RDN prolonged the ventricular effective refractory period (ERP) and the ventricular action potential duration, as well as decreased action potential duration dispersion. Although RDN is known to reduce renal sympathetic activity 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. Methods and 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 t...

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Section: Effect Of Rdn On Spontaneous and Induced Vasmentioning

confidence: 86%

Section: Effect Of Rdn On Spontaneous and Induced Vasmentioning

confidence: 99%

Effects of Renal Artery Denervation on Ventricular Arrhythmias in a Postinfarct Model

Jackson

Gizurarson

Azam

et al. 2017

Circ: Cardiovascular Interventions

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“…By using the same anesthesia method, both kidneys were approached through midabdominal incision. This chemical RDN has been reported before 13, 16. In brief, the rabbit underwent fasting for 1 night before the surgery.…”

Section: Methodsmentioning

confidence: 92%

Impact of Renal Denervation on Atrial Arrhythmogenic Substrate in Ischemic Model of Heart Failure

Yamada

Fong

Hsiao

et al. 2018

JAHA

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BackgroundMyocardial infarction increases the risk of heart failure (HF) and atrial fibrillation. Renal denervation (RDN) might suppress the development of atrial remodeling. This study aimed to elucidate the molecular mechanism of RDN in the suppression of atrial fibrillation in a HF model after myocardial infarction.Methods and Results HF rabbits were created 4 weeks after coronary ligation. Rabbits were classified into 3 groups: normal control (n=10), HF (n=10), and HF‐RDN (n=6). Surgical and chemical RDN were approached through midabdominal incisions in HF‐RDN. Left anterior descending coronary artery in HF and HF‐RDN was ligated to create myocardial infarction. After electrophysiological study, the rabbits were euthanized and the left atrial appendage was harvested for real‐time polymerase chain reaction analysis and Trichrome stain. Left atrial dimension and left ventricular mass were smaller in HF‐RDN by echocardiography compared with HF. Attenuated atrial fibrosis and tyrosine hydroxylase levels were observed in HF‐RDN compared with HF. The mRNA expressions of Cav1.2, Nav1.5, Kir2.1, KvLQT1, phosphoinositide 3‐kinase, AKT, and endothelial nitric oxide synthase in HF‐RDN were significantly higher compared with HF. The effective refractory period and action potential duration of HF‐RDN were significantly shorter compared with HF. Decreased atrial fibrillation inducibility was noted in HF‐RDN compared with HF (50% versus 100%, P<0.05).Conclusions RDN reversed atrial electrical and structural remodeling, and suppressed the atrial fibrillation inducibility in an ischemic HF model. The beneficial effect of RDN may be related to prevention of the downregulation of the phosphoinositide 3‐kinase/AKT/endothelial nitric oxide synthase signaling pathway.

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“…[16][17][18] Effects of RDN on trigger arrhythmias are also available from animal experiments. 7,19) RDN can even directly increase the ventricular effective refractory period 20,21) and action potential duration. 20) Aside from immediate antiarrhythmic properties, RDN ameliorates the symptoms of chronic heart failure and therefore eliminates VAs during a long-term follow up.…”

Section: Discussionmentioning

confidence: 99%

Renal Denervation for Ventricular Arrhythmia in Patients with Implantable Cardioverter Defibrillators

et al. 2018

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SummaryTo investigate the efficacy of renal denervation (RDN) on the recurrence of ventricular arrhythmia (VA) in Asian patients with implantable cardioverter defibrillators (ICDs).Eight ICD patients with recurrent VA episodes underwent RDN using an off-the-shelf saline-irrigated catheter. The pre-and postprocedural VA episodes were counted via ICD interrogation. All patients underwent successful RDN without any complications related to radiofrequency catheter ablation. The median follow-up was 15 months (range 6-30), and the median VA episodes per month were significantly reduced from 3.17 (range 0.33-15.33) to 0.10 (range 0-5.83) after RDN (P < 0.05).RDN is an effective suppressor of VA in Asian patients with ICDs.(Int Heart J Advance Publication)

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Renal denervation suppresses ventricular arrhythmias during acute ventricular ischemia in pigs

Cited by 130 publications

References 29 publications

Effects of Renal Artery Denervation on Ventricular Arrhythmias in a Postinfarct Model

Effects of Renal Artery Denervation on Ventricular Arrhythmias in a Postinfarct Model

Impact of Renal Denervation on Atrial Arrhythmogenic Substrate in Ischemic Model of Heart Failure

Renal Denervation for Ventricular Arrhythmia in Patients with Implantable Cardioverter Defibrillators

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