Highlights
- •Neuromodulation can be observed after ablation of ventricular arrhythmia.
- •The change of sympathetic tone after ablation differs among patients.
- •Elevated post-ablation sympathetic tone indicates an unsuccessful right ventricular outflow tract ablation.
Abstract
Background
The neuromodulation effect after ventricular arrhythmia (VA) ablation is unclear.
The study aimed to investigate skin sympathetic nerve activity (SKNA) changes in patients
receiving catheter ablations for idiopathic VA.
Methods
Of 43 patients with drug-refractory symptomatic VA receiving ablation, SKNA was continuously
recorded for 10 min during resting from electrocardiogram lead I configuration and
bipolar electrodes on the right arm 1 day before and 1 day after ablation.
Results
Twenty-two patients with acute procedure success and no recurrence during follow-ups
were classified as sustained success group (group 1). Other 21 patients were classified
as failed ablation group (group 2). Baseline SKNA showed no significant difference
between the two groups. Post-ablation SKNA in group 2 was significantly higher than
in group 1. In patients with ablation involved right ventricular outflow tract (RVOT),
the post-ablation SKNA was also significantly higher in group 2. In contrast, there
was no difference in post-ablation SKNA between groups in patients receiving non-RVOT
ablation.
Conclusion
The neuromodulation response after RVOT ablation may correspond to the sympathetic
nerve distribution at RVOT. Augmentation of sympathetic activity after VA ablation
indicates an unsuccessful VA suppression, especially in patients receiving ablation
of RVOT VA.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: November 23, 2022
Accepted:
October 24,
2022
Received in revised form:
October 4,
2022
Received:
August 13,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
