Author + information
- Received August 29, 2004
- Revision received February 21, 2005
- Accepted March 10, 2005
- Published online October 4, 2005.
- Markus Zarse, MD⁎,
- Jurgita Plisiene, MD†,
- Karl Mischke, MD⁎,
- Thomas Schimpf, MD⁎,
- Christian Knackstedt, MD⁎,
- Felix Gramley, MD⁎,
- Georg Mühlenbruch, MD⁎,
- Mathias Waldmann, MD⁎,
- Michael Schmid, MD⁎,§,
- Nima Hatam, MD⁎,§,
- Jürgen Graf, MD⁎,
- Dirk Schuster, MD⁎,
- Peter Hanrath, MD, FACC⁎,
- Dainius Pauza, PhD‡ and
- Patrick Schauerte, MD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Prof. Patrick Schauerte, Department of Cardiology, University of Technology, Pauwelsstrasse 30, 52074 Aachen, Germany
Objectives This study was designed to develop a technique to selectively increase the sympathetic tone to the heart by cardiac sympathetic nerve stimulation (SNS).
Background Access to the cardiac sympathetic neurons may allow modulating the adrenergic tone of the heart while avoiding systemic side effects.
Methods Cardiac sympathetic nerves course within neural sleeves along the subclavian artery. Because of this proximity, transvascular SNS was attempted with electrode catheters inside the subclavian artery in 16 pigs.
Results Right/left (R-/L-) SNS (20 Hz) during ventricular pacing at 200/min evoked a >100% increase of left ventricular systolic pressure (baseline: 51 ± 1 mm Hg; L-SNS: 118 ± 26 mm Hg; R-SNS: 116 ± 33 mm Hg; p < 0.001) while systemic vascular resistance remained unchanged. There was a sigmoid dose-response curve with rapid on- and offset of the effect during SNS initiation/cessation. Positive inotropic effects persisted for 12 h of continued SNS (n = 4). Besides positive dromotropic effects, L-SNS/R-SNS yielded a 41% and 77% sinus rate increase, respectively.
Conclusions The neural adrenergic tone to the heart can be selectively increased by catheter stimulation of cardiac efferent sympathetic nerves.
- Received August 29, 2004.
- Revision received February 21, 2005.
- Accepted March 10, 2005.
- American College of Cardiology Foundation