Evidence map›Paper›PMID 28219848›Full record

ArticleHeart rhythm2017

Bioelectronic neuromodulation of the paravertebral cardiac efferent sympathetic outflow and its effect on ventricular electrical indices.

Una Buckley, Ray W Chui, Pradeep S Rajendran, Tina Vrabec, Kalyanam Shivkumar, Jeffrey L Ardell

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart rhythm, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Review
  8. Cardiac Neuroanatomy and Fundamentals of Neurocardiology.Cardiac electrophysiology clinics · 2024
    Review
  9. Review
  10. Article
  11. Review
  12. Scalable and reversible axonal neuromodulation of the sympathetic chain for cardiac control.American journal of physiology. Heart and circulatory physiology · 2022
    Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Autonomic Regulation and Ventricular Arrhythmias.Current treatment options in cardiovascular medicine · 2018
    Review
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Una BuckleyUniversity of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California; UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California.
Ray W ChuiUniversity of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California; UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California; Molecular, Cellular, & Integrative Physiology Program, UCLA, Los Angeles, California.
Pradeep S RajendranUniversity of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California; UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California; Molecular, Cellular, & Integrative Physiology Program, UCLA, Los Angeles, California.
Tina VrabecDepartment of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.
Kalyanam ShivkumarUniversity of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California; UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California; Molecular, Cellular, & Integrative Physiology Program, UCLA, Los Angeles, California.
Jeffrey L ArdellUniversity of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, California; UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California; Molecular, Cellular, & Integrative Physiology Program, UCLA, Los Angeles, California. Electronic address: jardell@mednet.ucla.edu.

Funding

Myocardial infarction alters information processing within the intrinsic cardiac nervous systemF31HL127974 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI RAJENDRAN, PRADEEP SUNDARAM · 2015 to 2017
$72k
NHLBI NIH HHS F31 HL127974
6 · The paper itself

Abstract

backgroundNeuromodulation of the paravertebral ganglia by using symmetric voltage controlled kilohertz frequency alternating current (KHFAC) has the potential to be a reversible alternative to surgical intervention in patients with refractory ventricular arrhythmias. KHFAC creates scalable focal inhibition of action potential conduction.

objectiveThe purpose of this article was to evaluate the efficacy of KHFAC when applied to the T1-T2 paravertebral chain to mitigate sympathetic outflow to the heart.

methodsIn anesthetized, vagotomized, porcine subjects, the heart was exposed via a midline sternotomy along with paravertebral chain ganglia. The T3 paravertebral ganglion was electrically stimulated, and activation recovery intervals (ARIs) were obtained from a 56-electrode sock placed over both ventricles. A bipolar Ag electrode was wrapped around the paravertebral chain between T1 and T2 and connected to a symmetric voltage controlled KHFAC generator. A comparison of cardiac indices during T3 stimulation conditions, with and without KHFAC, provided a measure of block efficacy.

resultsRight-sided T3 stimulation (at 4 Hz) was titrated to produce reproducible ARI changes from baseline (52 ± 30 ms). KHFAC resulted in a 67% mitigation of T3 electrical stimulation effects on ARI (18.5 ± 22 ms; P < .005). T3 stimulation repeated after KHFAC produced equivalent ARI changes as control. KHFAC evoked a transient functional sympathoexcitation at onset that was inversely related to frequency and directly related to intensity. The optimum block threshold was 15 kHz and 15 V.

conclusionKHFAC applied to nexus (convergence) points of the cardiac nervous system produces a graded and reversible block of underlying axons. As such, KHFAC has the therapeutic potential for on-demand and reversible mitigation of sympathoexcitation.

Indexed as

Arrhythmias, CardiacHeart VentriclesAction PotentialsAnimalsDisease Models, AnimalHeart RateNeural ConductionStellate GanglionSwineTranscutaneous Electric Nerve StimulationAxonal modulation therapyKilohertz frequency alternating current (KHFAC)Paravertebral chainStellate ganglionSympathetic efferentVentricular electrical indices

Identifiers

PMID28219848
PMCPMC5478457

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.