Background
Stellate ganglion nerve activity (SGNA) is important in ventricular arrhythmogenesis. However, because thoracotomy is needed to access the stellate ganglion, it is difficult to use SGNA for risk stratification.
Objective
To test the hypothesis that subcutaneous nerve activity (SCNA) in canines can be used to estimate SGNA and predict ventricular arrhythmia.
Methods
We implanted radio transmitters to continuously monitor left stellate ganglion and subcutaneous electrical activities in 7 ambulatory dogs with myocardial infarction, complete heart block and nerve growth factor infusion to the left stellate ganglion.
Results
Spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) was documented in each dog. SCNA preceded a combined 61 episodes of VT and VF, 61 frequent bigeminy or couplets and 61 premature ventricular contractions within 15 s in 70%, 59% and 61% of arrhythmias, respectively. Similar incidence of 75%, 69% and 62% was noted for SGNA. Progressive increase in SCNA (48.9 (95% CI 39.3–58.5) vs. 61.8 (95% CI 45.9–77.6) vs. 75.1 (95% CI 57.5–92.7) mV-s) and SGNA (48.6 (95% CI 40.9–56.3) vs. 58.5 (95% CI 47.5–69.4) vs. 69.0 (95% CI 53.8–84.2) mV-s) integrated over 20 s intervals was demonstrated 60 s, 40 s and 20 s prior to VT/VF (p<0.05). The Pearson’s correlation coefficient for integrated SCNA and SGNA was 0.73±0.18 (p<0.0001 for all dogs, n=5). Both SCNA and SGNA exhibited circadian variation.
Conclusions
SCNA can be used as an estimate of SGNA to predict susceptibility to VT and VF in a canine model of ventricular arrhythmia and sudden cardiac death.