Persistent Proarrhythmic Neural Remodeling Despite Recovery From Premature Ventricular Contraction-Induced Cardiomyopathy

The presence and significance of neural remodeling in premature ventricular contraction-induced cardiomyopathy (PVC-CM) remain unknown. This study aimed to characterize cardiac sympathovagal balance and proarrhythmia in a canine model of PVC-CM. In 12 canines, the investigators implanted epicardial...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2020-01, Vol.75 (1), p.1-13
Main Authors: Tan, Alex Y., Elharrif, Khalid, Cardona-Guarache, Ricardo, Mankad, Pranav, Ayers, Owen, Joslyn, Martha, Das, Anindita, Kaszala, Karoly, Lin, Shien-Fong, Ellenbogen, Kenneth A., Minisi, Anthony J., Huizar, Jose F.
Format: Article
Language:English
Subjects:
Animals
Arrhythmia
autonomic nervous system
Blood pressure
Cardiac arrhythmia
Cardiology
Cardiomyopathies - diagnostic imaging
Cardiomyopathies - physiopathology
Cardiomyopathy
Clonidine
Contraction
Dogs
Echocardiography - methods
Electrocardiography - methods
Fitness equipment
Ganglia
Heart rate
Heart Rate - physiology
Hyperactivity
idiopathic ventricular arrhythmia
Laboratory animals
Myocardial Contraction - physiology
nonsustained ventricular tachycardia
Ostomy
Pacemakers
Physical training
Recovery (Medical)
Recovery of Function - physiology
Stellate ganglion
Substrates
Surgery
Surgical implants
Variance analysis
Ventricle
Ventricular Premature Complexes - diagnostic imaging
Ventricular Premature Complexes - physiopathology
Ventricular Remodeling - physiology
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Summary:The presence and significance of neural remodeling in premature ventricular contraction-induced cardiomyopathy (PVC-CM) remain unknown. This study aimed to characterize cardiac sympathovagal balance and proarrhythmia in a canine model of PVC-CM. In 12 canines, the investigators implanted epicardial pacemakers and radiotelemetry units to record cardiac rhythm and nerve activity (NA) from the left stellate ganglion (SNA), left cardiac vagus (VNA), and arterial blood pressure. Bigeminal PVCs (200 ms coupling) were applied for 12 weeks to induce PVC-CM in 7 animals then disabled for 4 weeks to allow complete recovery of left ventricular ejection fraction (LVEF), versus 5 sham controls. After 12 weeks of PVCs, LVEF (p = 0.006) and dP/dT (p = 0.007) decreased. Resting SNA (p = 0.002) and VNA (p = 0.04), exercise SNA (p = 0.01), SNA response to evoked PVCs (p = 0.005), heart rate (HR) at rest (p = 0.003), and exercise (p 
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2019.10.046