Simultaneous recordings of intrinsic cardiac nerve activity and skin sympathetic nerve activity from human patients during the postoperative period

Abstract

Background Intrinsic cardiac nerve activities (ICNA) and the skin nerve activities (SKNA) are both associated with cardiac arrhythmias in dogs. Objective To test the hypothesis that ICNA and SKNA correlate with postoperative cardiac arrhythmias in humans. Methods Eleven patients (60±13 years old; 4 female) were enrolled in this study. Electrical signals were simultaneously recorded from electrocardiogram (ECG) patch electrodes on the chest wall and from two temporary pacing wires placed during open heart surgery on the left atrial epicardial fat pad. The signals were filtered to display SKNA and ICNA. Premature atrial contractions (PAC) and premature ventricular contractions (PVC) were manually determined. The SKNA and ICNA of the first 300 min of each patient were calculated min-by-min to determine baseline average amplitudes of nerve activities and to determine their correlation with arrhythmia burden. Results We processed 1365±973 min of recording per patient. Low-amplitude SKNA and ICNA were present at all time, while the burst discharges were observed much less frequently. Both SKNA and burst ICNA were significantly associated with the onset of PACs and PVCs. Baseline average ICNA (aICNA), but not SKNA (aSKNA), had a significant association with PAC burden. The correlation coefficient (r) between aICNA and PAC burden was 0.78 (P<0.01). A patient with the greatest aICNA developed postoperative atrial fibrillation. Conclusions ICNA and SKNA can be recorded from human patients in the postoperative period. Baseline magnitude of ICNA correlates with PAC burden and development of postoperative atrial fibrillation.

Ganglionated plexi as neuromodulation targets for atrial fibrillation

“…Atrial tachyarrhythmia episodes were invariably preceded by intrinsic cardiac nerve activity, thus support- and noninvasively record human skin sympathetic nerve activity, 19 has shown that increased skin and intrinsic cardiac nerve activities were associated with the development of paroxysmal atrial tachyarrhythmia episodes in humans. 14,15 These findings are consistent with those observed in canine models.…”

“…The role of ANS on cardiac arrhythmogenesis was evaluated by direct recording of autonomic nerve activity in ambulatory animals 12,13 and in humans. 14,15 There was circadian variation in the sympathetic outflow from the canine stellate ganglia. Simultaneous sympathovagal discharges often precede paroxysmal atrial tachycardia (AT) events.…”

Cardiac Sympathetic Afferent Denervation Protects Against Ventricular Arrhythmias by Modulating Cardiac Sympathetic Nerve Activity During Acute Myocardial Infarction

“…Basic and clinical studies have suggested that increased cardiac sympathetic nerve activity is thought to contribute to VAs [ 18 – 21 ]. It is well known that AMI releases various metabolites including ATP, protons, bradykinin, and histamine that stimulate cardiac sympathetic afferent nerve endings and lead to an activation of sympathetic nerve activity [ 22 ].…”

Atrial Myopathy

“…Intrinsic cardiac nerve activities invariably preceded spontaneously occurring atrial tachyarrhythmias in a canine model of pacing-induced AF (75). In patients recovering from open heart surgery, these fat pad intrinsic cardiac nerve activities were associated with an increased burden of premature atrial complexes and might predict the development of post-operative AF (76).…”