Skin sympathetic nerve activity and ventricular arrhythmias in acute coronary syndrome

Huang, Tien‐Chi; Lin, Shin-Jing; Chen, Chang-Jen; Jhuo, Shih-Jie; Chang, Chien-Wei; Lin, Sheng-Fung; Chi, Nai-Yu; Chou, Li‐Fang; Tai, Li-Hsin; Liu, Yi-Hsueh; Lin, Tsung-Han; Liao, Wei-Sheng; Kao, Pei‐Heng; Cheng, Mu-Chun; Hsu, Po-Chao; Lee, Chee-Siong; Lin, Yi‐Hsiung; Lee, Hsiang‐Chun; Lu, Ye-Hsu; Yen, Hsueh‐Wei; Lin, Tsung‐Hsien; Su, Ho‐Ming; Lai, Wen‐Ter; Dai, Chia‐Yen; Lee, Chien-Hung; Chen, Peng‐Sheng; Lin, Shien‐Fong; Tsai, Wei–Chung

doi:10.1016/j.hrthm.2022.04.031

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…In addition to predicting AF recurrence, there are new applications in neuECG, such as acting as markers of orthostatic hypotension and recurrent syncope ( 30 , 31 ), predicting the occurrence of ventricular arrhythmia in acute coronary syndrome ( 32 ), and correlating with intradialytic weight gain in patients with end-stage renal disease ( 33 ). It has also been proposed as a marker of fitness ( 34 ) and to predict neurological recovery of patients who had cardiac arrest and are undergoing therapeutic hypothermia ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Alterations of sympathetic dynamics after atrial fibrillation ablation by analysis sympathetic nerve activity provide prognostic value for recurrence and mechanistic insights into ablation

Chen

Lin

Chuang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. Success is associated with autonomic function modulation; however, the relationship between the changes after ablation is not fully understood. We aimed to investigate the effect of ablation on autonomic modulation by skin sympathetic nerve activity (SKNA) using conventional electrocardiogram (ECG) electrodes and to predict the treatment success.MethodsWe enrolled 79 patients. We recorded neuECG for 10 min at 10 kHz before and after ablation. The NeuECG was bandpass-filtered (500–1,000 Hz) and integrated at intervals of 100 ms (iSKNA). iSKNA was averaged over different time windows (1-, 5-,10-s; aSKNAs), and burst analyses were derived from aSKNAs to quantify the dynamics of sympathetic activities. AF recurrence after 3 months was defined as the study endpoint.ResultsSixteen patients experienced AF recurrence after the ablation. For burst analysis of 1-s aSKNA, the recurrence group had a higher bursting frequency than the non-recurrence group (0.074 ± 0.055 vs. 0.109 ± 0.067; p < 0.05) before ablation. The differences between pre- and post-ablation of firing duration longer than 2 s were more in the non-recurrence group (2.75 ± 6.41 vs. −1.41 ± 5.14; p < 0.05), while no significant changes were observed in the percentage of duration longer than 10 s using 5-s aSKNA. In addition, decreases in differences in firing frequency and percentage of both overall firing duration and longer firing duration (> 2 s) between pre- and post-ablation were independently associated with AF recurrence and more area under receiver operating characteristics (ROC) curve in combination with CHADS2 score (0.833).ConclusionWe demonstrated the applicability of neuECG for determining sympathetic modulation during AF ablation. Decreasing sympathetic activity is the key to successful ablation.

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Section: Discussionmentioning

confidence: 99%

Alterations of sympathetic dynamics after atrial fibrillation ablation by analysis sympathetic nerve activity provide prognostic value for recurrence and mechanistic insights into ablation

Chen

Lin

Chuang

et al. 2022

Front. Cardiovasc. Med.

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“…The burst amplitude is correlated to both skin blood flow reduction rate and sweat rate change. As a non‐invasive sympathetic activity assessment method, SSNA has been widely used to predict sympathetic tone in cardiac diseases, neurological disorders, sleep apnea, etc 112–116 . The ICH classification and outcome prediction based on the SSNA signal had been proved to be a feasible method 114 .…”

Section: Assessmentmentioning

confidence: 99%

“…Skin sympathetic nerve activity (SSNA) is microneurographically recorded from the skin nerve fascicle in the peripheral nerves, which is characterized by burst activity followed by vasoconstriction and/or sweating, and usually elicited by mental stress and arousal stimulation. 112 , 113 , 114 It comprises vasoconstrictor (VC), sudomotor (SM) activity, and vasodilator (VD) activity. The burst amplitude is correlated to both skin blood flow reduction rate and sweat rate change.…”

Section: Assessmentmentioning

confidence: 99%

“…As a non‐invasive sympathetic activity assessment method, SSNA has been widely used to predict sympathetic tone in cardiac diseases, neurological disorders, sleep apnea, etc. 112 , 113 , 114 , 115 , 116 The ICH classification and outcome prediction based on the SSNA signal had been proved to be a feasible method. 114 Sympathetic skin response (SSR) is also a kind of epidermal potential that is related to sweat gland activity and reflects the function of sympathetic nervous system.…”

Section: Assessmentmentioning

confidence: 99%

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Autonomic dysfunction and treatment strategies in intracerebral hemorrhage

Kang,

Shi,

Liu

et al. 2024

CNS Neurosci Ther

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AimsAutonomic dysfunction with central autonomic network (CAN) damage occurs frequently after intracerebral hemorrhage (ICH) and contributes to a series of adverse outcomes. This review aims to provide insight and convenience for future clinical practice and research on autonomic dysfunction in ICH patients.DiscussionWe summarize the autonomic dysfunction in ICH from the aspects of potential mechanisms, clinical significance, assessment, and treatment strategies. The CAN structures mainly include insular cortex, anterior cingulate cortex, amygdala, hypothalamus, nucleus of the solitary tract, ventrolateral medulla, dorsal motor nucleus of the vagus, nucleus ambiguus, parabrachial nucleus, and periaqueductal gray. Autonomic dysfunction after ICH is closely associated with neurological functional outcomes, cardiac complications, blood pressure fluctuation, immunosuppression and infection, thermoregulatory dysfunction, hyperglycemia, digestive dysfunction, and urogenital disturbances. Heart rate variability, baroreflex sensitivity, skin sympathetic nerve activity, sympathetic skin response, and plasma catecholamine concentration can be used to assess the autonomic functional activities after ICH. Risk stratification of patients according to autonomic functional activities, and development of intervention approaches based on the restoration of sympathetic‐parasympathetic balance, would potentially improve clinical outcomes in ICH patients.ConclusionThe review systematically summarizes the evidence of autonomic dysfunction and its association with clinical outcomes in ICH patients, proposing that targeting autonomic dysfunction could be potentially investigated to improve the clinical outcomes.

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“…We recently performed a study to prospectively measure the SKNA in 128 patients with acute coronary syndrome (ACS) and compare the magnitude with that of control subjects. 26 The neuECG was recorded with ECG lead I configuration at baseline, during mental math stress, and during recovery. Approximately 55% of patients with ACS have ST-segment elevation myocardial infarction (STEMI) and 45% have non–ST-segment elevation ACS.…”

Section: Skna Elevation and MImentioning

confidence: 99%