Effect of the stellate ganglion on atrial fibrillation and atrial electrophysiological properties and its left-right asymmetry in a canine model

Abstract

Objective: To investigate the effect of the stellate ganglion (SG) and its left-right asymmetry on atrial fibrillation (AF) inducibility, AF duration and atrial electrophysiological properties.

Methods: Sixteen adult mongrel dogs were randomly assigned to three groups. The control group (n=4) underwent 6 h rapid atrial pacing (RAP) only; the right SG (RSG) group (n=6) underwent 6 h RSG stimulation plus RAP; and the left SG (LSG) group (n=6) underwent 6 h LSG stimulation plus RAP. AF induction rate, AF duration, effective refractory period (ERP) and dispersion of ERP (dERP) were measured.

Results: In the RSG group, the induction rate of AF was significantly increased in sites in the right atrium (RA) compared with baseline (P<0.05). In the LSG group, the induction rate of AF was significantly increased (P<0.05) compared with baseline in the left atrium (LA), left superior pulmonary vein and left inferior pulmonary vein, respectively. Compared with RSG stimulation, right stellate ganglionectomy markedly decreased the AF induction rate of the RA (P<0.05). Compared with LSG stimulation, left stellate ganglionectomy markedly decreased the AF induction rate of the LA, the left superior pulmonary vein and the left inferior pulmonary vein (P<0.05). In the RSG group, the ERP was significantly shortened (P<0.05) and the dERP was significantly increased (P<0.05) in RA sites (P<0.05). The ERP was significantly shortened in the LSG group (P<0.05). The dERP was significantly increased (P<0.05) in LA and pulmonary vein sites (P<0.05).

Conclusions: Unilateral electrical stimulation of the SG in combination with RAP can successfully establish a canine model of acute AF mediated by excessive sympathetic activity. SG stimulation facilitates AF induction and aggravates electrical remodelling in sites in the atrium and pulmonary vein. Inhibiting sympathetic nerve activation through unilateral stellate ganglionectomy can reduce AF initiation.

Keywords: Atrial fibrillation; Stellate ganglion; Sympathetic nerve.

Figures

Figure 1)

Stellate ganglion. L Left; R Right

Figure 2)

Asymmetry of stellate ganglion on heart rate (HR) and systolic blood pressure (SBP).APercentage change in heart rate.BPercentage change in SBP. *P<0.05 between right stellate ganglion (RSG) group and left stellate ganglion (LSG) group

Figure 3)

Effect and asymmetry of stellate ganglion on the effective refractory period (ERP) in the right atrium (RA) (A), the left atrium (LA) (B), the left superior pulmonary vein (LSPV) (C) and the left inferior pulmonary vein (LIPV) (D). *P<0.05 compared with baseline in the same group; †P<0.05 compared with resection in the same group. LA Left atrium; LSG Left stellate ganglion; RSG Right stellate ganglion; Sti Stimulation

Figure 4)

Effect and asymmetry of the stellate ganglion on the dispersion of the effective refractory period (dERP). *P†P<0.05 compared with control group in the same intervention status. LSG Left stellate ganglion; RSG Right stellate ganglion; Sti Stimulation