Thoracic dorsal root ganglion stimulation reduces acute myocardial ischemia induced ventricular arrhythmias

Yuki Kuwabara; Kimberly Howard-Quijano; Siamak Salavatian; Tomoki Yamaguchi; Samir Saba; Aman Mahajan

doi:10.3389/fnins.2023.1091230

Thoracic dorsal root ganglion stimulation reduces acute myocardial ischemia induced ventricular arrhythmias

Front Neurosci. 2023 Jan 30:17:1091230. doi: 10.3389/fnins.2023.1091230. eCollection 2023.

Authors

Yuki Kuwabara¹, Kimberly Howard-Quijano^{1

2}, Siamak Salavatian^{1

3}, Tomoki Yamaguchi¹, Samir Saba³, Aman Mahajan^{1

2}

Affiliations

¹ Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
² Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
³ Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

Abstract

Background: Dorsal root ganglion stimulation (DRGS) may serve as a novel neuromodulation strategy to reduce cardiac sympathoexcitation and ventricular excitability.

Objective: In this pre-clinical study, we investigated the effectiveness of DRGS on reducing ventricular arrhythmias and modulating cardiac sympathetic hyperactivity caused by myocardial ischemia.

Methods: Twenty-three Yorkshire pigs were randomized to two groups, which was control LAD ischemia-reperfusion (CONTROL) or LAD ischemia-reperfusion + DRGS (DRGS) group. In the DRGS group (n = 10), high-frequency stimulation (1 kHz) at the second thoracic level (T2) was initiated 30 min before ischemia and continued throughout 1 h of ischemia and 2 h of reperfusion. Cardiac electrophysiological mapping and Ventricular Arrhythmia Score (VAS) were assessed, along with evaluation of cFos expression and apoptosis in the T2 spinal cord and DRG.

Results: DRGS decreased the magnitude of activation recovery interval (ARI) shortening in the ischemic region (CONTROL: -201 ± 9.8 ms, DRGS: -170 ± 9.4 ms, p = 0.0373) and decreased global dispersion of repolarization (DOR) at 30 min of myocardial ischemia (CONTROL: 9546 ± 763 ms², DRGS: 6491 ± 636 ms², p = 0.0076). DRGS also decreased ventricular arrhythmias (VAS-CONTROL: 8.9 ± 1.1, DRGS: 6.3 ± 1.0, p = 0.038). Immunohistochemistry studies showed that DRGS decreased % cFos with NeuN expression in the T2 spinal cord (p = 0.048) and the number of apoptotic cells in the DRG (p = 0.0084).

Conclusion: DRGS reduced the burden of myocardial ischemia-induced cardiac sympathoexcitation and has a potential to be a novel treatment option to reduce arrhythmogenesis.

Keywords: autonomic nervous system; cardiac electrophysiology; dorsal root ganglion stimulation; myocardial ischemia; sudden cardiac death; ventricular arrhythmias.

Abstract

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