Low-Level Electrical Stimulation of Aortic Root Ventricular Ganglionated Plexi Attenuates Autonomic Nervous System-Mediated Atrial Fibrillation

Hong-Tao Wang; Ming Xu; Boyuan Fan; Xiong-Tao Liu; Fei-Fei Su; Di Zeng; Jun Ren; Qiang-Sun Zheng

doi:10.1016/j.jacep.2015.06.004

Low-Level Electrical Stimulation of Aortic Root Ventricular Ganglionated Plexi Attenuates Autonomic Nervous System-Mediated Atrial Fibrillation

JACC Clin Electrophysiol. 2015 Oct;1(5):390-397. doi: 10.1016/j.jacep.2015.06.004. Epub 2015 Aug 20.

Authors

Hong-Tao Wang¹, Ming Xu², Boyuan Fan¹, Xiong-Tao Liu¹, Fei-Fei Su¹, Di Zeng¹, Jun Ren³, Qiang-Sun Zheng⁴

Affiliations

¹ Division of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
² Department of Physiology, School of Basic Medical Sciences, Fourth Military Medical University, Xi'an, China.
³ College of Health Sciences, University of Wyoming, Laramie, Wyoming. Electronic address: jren@uwyo.edu.
⁴ Division of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China. Electronic address: qiangsun_tdxn@hotmail.com.

PMID: 29759467
DOI: 10.1016/j.jacep.2015.06.004

Abstract

Objectives: This study investigated the effect of electrical stimulation of aortic root ventricular ganglionated plexi (GP) on atrial fibrillation (AF) inducibility.

Background: The ventricular GP are interconnected with atrial GP to govern heart function, although the effect of ventricular GP modification on control of AF remains unknown.

Methods: Effective refractory periods (ERPs) of test pulmonary veins (PVs) were measured at baseline and during high-level (HL-ES) and low-level (LL-ES) electrical stimulation of the aortic root GP. The arrhythmogenic threshold of acetylcholine and isoproterenol was determined at baseline and during HL-ES and LL-ES. Moreover, AF was induced at PVs by programmed electrical stimulation after HL-ES or LL-ES. Immunohistochemistry staining was performed to examine the autonomic activity from aortic root GP to the PVs.

Results: Compared with the baseline group, HL-ES of aortic root GP significantly shortened atrial ERP (95 ± 13 ms vs. 122 ± 9 ms) and PV ERP (104 ± 11 ms vs. 131 ± 12 ms); decreased the threshold concentration of AF by both acetylcholine (1.3 ± 0.2 μmol/l vs. 3.2 ± 0.3 μmol/l) and isoproterenol (0.3 ± 0.1 μmol/l vs. 1.3 ± 0.2 μmol/l); and increased the AF-inducing rate from PVs (90% vs. 30%). In contrast, LL-ES of the GP prevented the shortening of ERP and PV ERP to 125 ± 10 ms and 133 ± 11 ms, respectively; increased threshold levels of acetylcholine and isoproterenol to 5.7 ± 0.4 μmol/l and 3.2 ± 0.3 μmol/l; and decreased the AF-inducing rate to 5%. We also found that the biotinylated dextran amine-containing varicose fibers projected directly from the aortic root GP to the left PVs.

Conclusions: These findings suggest that autonomic innervations of left PVs partly originated from aortic root ventricular GP. Moreover, LL-ES of aortic root ventricular GP suppressed AF inducibility and arose from PVs mediated by the autonomic nervous system.

Keywords: aortic root ventricular ganglionated plexi; atrial fibrillation; autonomic nervous system; pulmonary veins.