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Renal denervation decreases effective refractory period but not inducibility of ventricular fibrillation in a healthy porcine biomodel: a case control study.

Lubanda JC, Kudlicka J, Mlcek M, Chochola M, Neuzil P, Linhart A, Kittnar O - J Transl Med (2015)

Bottom Line: According to histological findings, RDN procedure was successfully performed in all biomodels.RDN decreased the influence of sympathetic nerve system on the heart conduction system in healthy porcine biomodel.However, the electrophysiological study was not associated with a decrease of VF inducibility after RDN.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, Prague 2, 128 00, Czech Republic. jean-claude.lubanda@vfn.cz.

ABSTRACT

Background: Ventricular arrhythmias play an important role in cardiovascular mortality especially in patients with impaired cardiac and autonomic function. The aim of this experimental study was to determine, if renal denervation (RDN) could decrease the inducibility of ventricular fibrillation (VF) in a healthy porcine biomodel.

Methods: Controlled electrophysiological study was performed in 6 biomodels 40 days after RDN (RDN group) and in 6 healthy animals (control group). The inducibility of VF was tested by programmed ventricular stimulation from the apex of right ventricle (8 basal stimuli coupled with up to 4 extrastimuli) always three times in each biomodel using peripheral extracorporeal oxygenation for hemodynamic support. Further, basal heart rate (HR), PQ and QT intervals and effective refractory period of ventricles (ERP) were measured. Technical success of RDN was evaluated by histological examination.

Results: According to histological findings, RDN procedure was successfully performed in all biomodels. Comparing the groups, basal HR was lower in RDN group: 79 (IQR 58; 88) vs. 93 (72; 95) beats per minute (p = 0.003); PQ interval was longer in RDN group: 145 (133; 153) vs. 115 (113; 120) ms (p < 0.0001) and QTc intervals were comparable: 402 (382; 422) ms in RDN vs. 386 (356; 437) ms in control group (p = 0.1). ERP was prolonged significantly in RDN group: 159 (150; 169) vs. 140 (133; 150) ms (p = 0.001), but VF inducibility was the same (18/18 vs. 18/18 attempts).

Conclusions: RDN decreased the influence of sympathetic nerve system on the heart conduction system in healthy porcine biomodel. However, the electrophysiological study was not associated with a decrease of VF inducibility after RDN.

No MeSH data available.


Related in: MedlinePlus

Histological finding of renal artery 40 days after successful renal denervation. In the left portion of the image extensive fibrosis of the intima, the media and fragmentation of the lamina elastica externa and the adventicia depicted.
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Fig4: Histological finding of renal artery 40 days after successful renal denervation. In the left portion of the image extensive fibrosis of the intima, the media and fragmentation of the lamina elastica externa and the adventicia depicted.

Mentions: The electrophysiological parameters and VF inducibility data are summarized in Table 1 and Figure 3. According to histological findings, destruction of perirenal nerves was successful in both arteries in each case regardless of used ablation catheter (Figure 4). No arterial stenosis or endothelial damage was found 40 days after RDN.Table 1


Renal denervation decreases effective refractory period but not inducibility of ventricular fibrillation in a healthy porcine biomodel: a case control study.

Lubanda JC, Kudlicka J, Mlcek M, Chochola M, Neuzil P, Linhart A, Kittnar O - J Transl Med (2015)

Histological finding of renal artery 40 days after successful renal denervation. In the left portion of the image extensive fibrosis of the intima, the media and fragmentation of the lamina elastica externa and the adventicia depicted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4300561&req=5

Fig4: Histological finding of renal artery 40 days after successful renal denervation. In the left portion of the image extensive fibrosis of the intima, the media and fragmentation of the lamina elastica externa and the adventicia depicted.
Mentions: The electrophysiological parameters and VF inducibility data are summarized in Table 1 and Figure 3. According to histological findings, destruction of perirenal nerves was successful in both arteries in each case regardless of used ablation catheter (Figure 4). No arterial stenosis or endothelial damage was found 40 days after RDN.Table 1

Bottom Line: According to histological findings, RDN procedure was successfully performed in all biomodels.RDN decreased the influence of sympathetic nerve system on the heart conduction system in healthy porcine biomodel.However, the electrophysiological study was not associated with a decrease of VF inducibility after RDN.

View Article: PubMed Central - PubMed

Affiliation: 2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, Prague 2, 128 00, Czech Republic. jean-claude.lubanda@vfn.cz.

ABSTRACT

Background: Ventricular arrhythmias play an important role in cardiovascular mortality especially in patients with impaired cardiac and autonomic function. The aim of this experimental study was to determine, if renal denervation (RDN) could decrease the inducibility of ventricular fibrillation (VF) in a healthy porcine biomodel.

Methods: Controlled electrophysiological study was performed in 6 biomodels 40 days after RDN (RDN group) and in 6 healthy animals (control group). The inducibility of VF was tested by programmed ventricular stimulation from the apex of right ventricle (8 basal stimuli coupled with up to 4 extrastimuli) always three times in each biomodel using peripheral extracorporeal oxygenation for hemodynamic support. Further, basal heart rate (HR), PQ and QT intervals and effective refractory period of ventricles (ERP) were measured. Technical success of RDN was evaluated by histological examination.

Results: According to histological findings, RDN procedure was successfully performed in all biomodels. Comparing the groups, basal HR was lower in RDN group: 79 (IQR 58; 88) vs. 93 (72; 95) beats per minute (p = 0.003); PQ interval was longer in RDN group: 145 (133; 153) vs. 115 (113; 120) ms (p < 0.0001) and QTc intervals were comparable: 402 (382; 422) ms in RDN vs. 386 (356; 437) ms in control group (p = 0.1). ERP was prolonged significantly in RDN group: 159 (150; 169) vs. 140 (133; 150) ms (p = 0.001), but VF inducibility was the same (18/18 vs. 18/18 attempts).

Conclusions: RDN decreased the influence of sympathetic nerve system on the heart conduction system in healthy porcine biomodel. However, the electrophysiological study was not associated with a decrease of VF inducibility after RDN.

No MeSH data available.


Related in: MedlinePlus