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|Title:||Catheter-based renal denervation reduces atrial nerve sprouting and complexity of atrial fibrillation in goats|
Van Hunnik, A.
|Citation:||Circulation: Arrhythmia and Electrophysiology, 2015; 8(2):466-474|
|Publisher:||American Heart Association|
|Dominik Linz, Arne van Hunnik, Mathias Hohl, Felix Mahfoud, Milan Wolf, Hans-Ruprecht Neuberger, MD, Barbara Casadei, Svetlana N. Reilly, Sander Verheule, Michael Böhm, Ulrich Schotten|
|Abstract:||Background: Atrial fibrillation (AF) leads to structural and neural remodeling in the atrium, which enhances AF complexity and perpetuation. Renal denervation (RDN) can reduce renal and whole-body sympathetic activity. Aim of this study was to determine the effect of sympathetic nervous system modulation by RDN on atrial arrhythmogenesis. Methods and Result: Eighteen goats were instrumented with an atrial endocardial pacemaker lead and a burst pacemaker. Percutaneous catheter-based RDN was performed in 8 goats (RDN-AF). Ten goats undergoing a sham procedure served as control (SHAM-AF). AF was induced and maintained by burst pacing for 6 weeks. High-resolution mapping was used to record epicardial conduction patterns of the right and left atrium. RDN reduced tyrosine hydroxylase-positive sympathetic nerve staining and resulted in lower transcardiac norepinephrine levels. This was associated with reduced expression of nerve growth factor-β, indicating less atrial nerve sprouting. Atrial endomysial fibrosis content was lower and myocyte diameter was smaller in RDN-AF. Median conduction velocity was higher (75 ± 9 versus 65 ± 10 cm/s, P = 0.02), and AF cycle length was shorter in RDN-AF compared with SHAM-AF. Left atrial AF complexity (4.8 ± 0.8 fibrillation waves/AF cycle length versus 8.5 ± 0.8 waves/AF cycle length, P = 0.001) and incidence of breakthroughs (2.0 ± 0.3 versus 4.3 ± 0.5 waves/AF cycle length, P = 0.059) were lower in RDN-AF compared with SHAM-AF. Blood pressure was normal and not significantly different between the groups. Conclusions: RDN reduces atrial sympathetic nerve sprouting, structural alterations, and AF complexity in goats with persistent AF, independent of changes in blood pressure.|
|Keywords:||Atrial fibrillation; autonomic nervous system; complexity; mapping; nerve sprouting; remodeling; renal denervation|
|Rights:||© 2015 American Heart Association, Inc.|
|Appears in Collections:||Medicine publications|
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