Renal denervation suppresses ventricular arrhythmias during acute ventricular ischemia in pigs
TL;DR: RDN reduced the occurrence of ventricular arrhythmias/fibrillation and attenuated the rise in LVEDP during left ventricular ischemia without affecting infarct size, changes in ventricular contractility, blood pressure, and reperfusion arrh rhythmias.
About: This article is published in Heart Rhythm.The article was published on 2013-10-01. It has received 207 citations till now. The article focuses on the topics: Ventricular pressure & Ventricular fibrillation.
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TL;DR: Neural modulation as a treatment for arrhythmias has been well established in certain diseases, such as long QT syndrome, however, in most other arrhythmia diseases, it is still an emerging modality and under investigation.
Abstract: The autonomic nervous system plays an important role in the modulation of cardiac electrophysiology and arrhythmogenesis. Decades of research has contributed to a better understanding of the anatomy and physiology of cardiac autonomic nervous system and provided evidence supporting the relationship of autonomic tone to clinically significant arrhythmias. The mechanisms by which autonomic activation is arrhythmogenic or antiarrhythmic are complex and different for specific arrhythmias. In atrial fibrillation, simultaneous sympathetic and parasympathetic activations are the most common trigger. In contrast, in ventricular fibrillation in the setting of cardiac ischemia, sympathetic activation is proarrhythmic, whereas parasympathetic activation is antiarrhythmic. In inherited arrhythmia syndromes, sympathetic stimulation precipitates ventricular tachyarrhythmias and sudden cardiac death except in Brugada and J-wave syndromes where it can prevent them. The identification of specific autonomic triggers in different arrhythmias has brought the idea of modulating autonomic activities for both preventing and treating these arrhythmias. This has been achieved by either neural ablation or stimulation. Neural modulation as a treatment for arrhythmias has been well established in certain diseases, such as long QT syndrome. However, in most other arrhythmia diseases, it is still an emerging modality and under investigation. Recent preliminary trials have yielded encouraging results. Further larger-scale clinical studies are necessary before widespread application can be recommended.
610 citations
TL;DR: The beneficial effects of bilateral CSD extend beyond the acute postsympathectomy period, with continued freedom from ICD shocks in 48% of patients and a significant reduction in ICDshocks during follow-up compared to the 12 months before.
301 citations
Patent•
15 May 2014
TL;DR: In this article, a pulsed electric field was used to induce electroporation or electrofusion for renal neuromodulation, which may reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease.
Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for extravascular delivery of pulsed electric fields to achieve such neuromodulation.
291 citations
TL;DR: CSD decreased sustained VT and ICD shock recurrence in patients with refractory VT and the value of CSD and the characteristics associated with outcomes in this population was assessed.
216 citations
Patent•
06 Jun 2014
TL;DR: In this paper, the authors proposed methods that block, reduce and/or inhibit renal sympathetic nerve activity to achieve a reduction in central sympathetic tone, which may carry several therapeutic benefits across many disease states.
Abstract: Methods for therapeutic renal denervation are disclosed herein One aspect of the present application, for example, is directed to methods that block, reduce and/or inhibit renal sympathetic nerve activity to achieve a reduction in central sympathetic tone Renal sympathetic nerve activity may be altered or modulated along the afferent and/or efferent pathway The achieved reduction in central sympathetic tone may carry several therapeutic benefits across many disease states
134 citations
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TL;DR: Application of the patch-clamp technique to CN-treated mammalian heart cells reveals specific K+ channels which are depressed by intracellular ATP (ATPi) at levels greater than 1 mM, which seems to be important for regulation of cellular energy metabolism in the control of membrane excitability.
Abstract: An outward current of unknown nature increases significantly when cardiac cells are treated with cyanide or subjected to hypoxia, and decreases on intracellular injection of ATP. We report here that application of the patch-clamp technique to CN-treated mammalian heart cells reveals specific K+ channels which are depressed by intracellular ATP (ATPi) at levels greater than 1 mM. For these channels, conductance in the outward direction is much larger than the inward rectifier K+ channel which is insensitive to ATP. AMP had no effect on the ATP-sensitive K+ channel, and ADP was less effective than ATP. Thus, the ATP-sensitive K+ channel seems to be important for regulation of cellular energy metabolism in the control of membrane excitability.
2,343 citations
The Heart Research Institute1, University of Erlangen-Nuremberg2, Saarland University3, Barts Health NHS Trust4, John Hunter Hospital5, Université catholique de Louvain6, University of Kiel7, University of Cologne8, Leipzig University9, Medical University of Vienna10, Complutense University of Madrid11, St. Vincent's Health System12, University of Duisburg-Essen13, Canterbury Hospital14, University of Zurich15, University of Glasgow16, Auckland City Hospital17, University of Freiburg18, Jagiellonian University19, Stanford University20, Harvard University21
TL;DR: Catheter-based renal denervation can safely be used to substantially reduce blood pressure in treatment-resistant hypertensive patients and should be continued, according to the authors.
2,200 citations
TL;DR: In this article, a proof-of-principle trial of therapeutic renal sympathetic denervation in patients with resistant hypertension (i.e., systolic blood pressure ≥160 mm/hg on three or more antihypertensive medications, including a diuretic) was conducted to assess safety and blood-pressure reduction effectiveness.
1,985 citations
Journal Article•
TL;DR: Catheter-based renal denervation causes substantial and sustained blood-pressure reduction, without serious adverse events, in patients with resistant hypertension, in a proof-of-principle trial of therapeutic renal sympathetic denervation.
1,284 citations
TL;DR: The Lambeth Conventions are guidelines intended to be of practical value in the investigation of arrhythmias induced by ischaemia, infarction, and reperfusion and are encouraged to adopt in the hope that this will improve uniformity and interlaboratory comparisons.
Abstract: The Lambeth Conventions are guidelines intended to be of practical value in the investigation of arrhythmias induced by ischaemia, infarction, and reperfusion. They cover the design and execution of experiments and the definition, classification, quantification, and analysis of arrhythmias. Investigators are encouraged to adopt the conventions in the hope that this will improve uniformity and interlaboratory comparisons.
1,105 citations