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Effect of renal sympathetic denervation on the inducibility of atrial fibrillation during rapid atrial pacing

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Atrial fibrillation (AF) is associated with activity of renin–angiotensin–aldosterone system (RAAS). Reduction in renal noradrenaline spillover could be achieved after renal sympathetic denervation (RSD). The relationship between RSD and AF is unknown.

Objective

The objective of the study was to investigate the inducibility of AF during atrial rapid pacing after RSD.

Methods

Thirteen dogs were used for the study as follows: control group (seven dogs) and RSD group (six dogs). In the control group, dogs were subjected to atrial pacing at 800 beats/min for 7 h, and atrial effective refractory period (AERP) was measured every hour in the status of non-pacing. Subsequently, pacing was stopped and the burst pacing (500 bpm) was repeated to induce AF three times. In the RSD group, after each renal artery ablation, the procedure of pacing and electrophysiological measurement was exactly same as in the control group. Blood was collected before and after pacing to measure the levels of renin, angiotensin II and aldosterone.

Results

There was a persistent decrease in AERP in both groups. However, 7 h after cessation of pacing, the induced number of times and duration of AF were higher in the control group than that in the RSD group (1.0 ± 1.26 vs 3.14 ± 2.54, P = 0.03; 16.5 ± 25.1 vs 86.6 ± 116.4, P = 0.02). The plasma aldosterone concentration increased significantly 7 h after rapid pacing in control group (renin, 119.8 ± 31.1 vs 185.3 ± 103.5 pg/ml, P < 0.01; aldosterone, 288.2 ± 43.1 vs 369.6 ± 109.8 pg/ml, P = 0.01). The levels of renin and aldosterone showed a decreasing trend in RSD group, but this did not attain statistical significance.

Conclusions

Episodes of AF could be decreased by renal sympathetic denervation during short-time rapid atrial pacing. This effect might have relationship with decreased activity of RAAS.

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Acknowledgments

We thank Dr. Hongyao Hu for his support; Xiaohong Wang and Huafen Liu for their assistance; and Yu Liu for providing the multi-polar electrode catheters used in this study. This work was supported by National Natural Science Foundation of China (81070144).

Conflict of interests

The authors have no conflict of interests to disclose.

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Authors and Affiliations

  1. Cardiovascular Research Institute of Wuhan University, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan City, 430060, People’s Republic of China

    Qingyan Zhao, Shengbo Yu, Minghui Zou, Zixuan Dai, Xule Wang, Jinping Xiao & Congxin Huang

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  1. Qingyan Zhao
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  2. Shengbo Yu
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  3. Minghui Zou
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  4. Zixuan Dai
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Correspondence to Congxin Huang.

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Editorial Commentary

This manuscript describes the role of innervation in kidneys, and the compounds released in the inducibility of AF may set the stage for others to complete a comprehensive mechanistic study.

Qingyan Zhao and Shengbo Yu contributed equally to this work.

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Zhao, Q., Yu, S., Zou, M. et al. Effect of renal sympathetic denervation on the inducibility of atrial fibrillation during rapid atrial pacing. J Interv Card Electrophysiol 35, 119–125 (2012). https://doi.org/10.1007/s10840-012-9717-y

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  • DOI: https://doi.org/10.1007/s10840-012-9717-y

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