Anisiia Doytchinova1, Jonathan L Hassel1, Yuan Yuan2, Hongbo Lin3, Dechun Yin4, David Adams1, Susan Straka1, Keith Wright1, Kimberly Smith1, David Wagner1, Changyu Shen3, Vicenta Salanova5, Chad Meshberger5, Lan S Chen5, John C Kincaid5, Arthur C Coffey6, Gang Wu7, Yan Li8, Richard J Kovacs1, Thomas H Everett1, Ronald Victor9, Yong-Mei Cha10, Shien-Fong Lin11, Peng-Sheng Chen12. 1. Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. 2. Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. 3. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana. 4. Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, the First Affiliated Hospital of Harbin Medical University, Harbin, China. 5. Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana. 6. Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana. 7. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. 8. Department of Geriatrics, Shengjing Hospital, China Medical University, Shenyang, China. 9. Cedars-Sinai Heart Institute/Hypertension Center(,) Los Angeles, California. 10. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota. 11. Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan. 12. Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: chenpp@iu.edu.
Abstract
BACKGROUND: Sympathetic nerve activity is important to cardiac arrhythmogenesis. OBJECTIVE: The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. METHODS: We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. RESULTS: In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1-V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P < .001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P < .05) and shortening of QT interval (P < .001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. CONCLUSION: SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.
BACKGROUND: Sympathetic nerve activity is important to cardiac arrhythmogenesis. OBJECTIVE: The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. METHODS: We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. RESULTS: In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1-V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P < .001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P < .05) and shortening of QT interval (P < .001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. CONCLUSION: SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.
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Authors: Yuan Yuan; Jonathan L Hassel; Anisiia Doytchinova; David Adams; Keith C Wright; Chad Meshberger; Lan S Chen; Maria P Guerra; Changyu Shen; Shien-Fong Lin; Thomas H Everett; Vicenta Salanova; Peng-Sheng Chen Journal: Heart Rhythm Date: 2017-08-01 Impact factor: 6.343
Authors: Andrea Uradu; Juyi Wan; Anisiia Doytchinova; Keith C Wright; Andrew Y T Lin; Lan S Chen; Changyu Shen; Shien-Fong Lin; Thomas H Everett; Peng-Sheng Chen Journal: Heart Rhythm Date: 2017-03-24 Impact factor: 6.343
Authors: Awaneesh Kumar; Keith Wright; Domingo E Uceda; Peter A Vasallo; Perry L Rabin; David Adams; Johnson Wong; Mithilesh Das; Shien-Fong Lin; Peng-Sheng Chen; Thomas H Everett Journal: Heart Rhythm Date: 2019-10-09 Impact factor: 6.343
Authors: Takashi Kusayama; Juyi Wan; Anisiia Doytchinova; Johnson Wong; Ryan A Kabir; Gloria Mitscher; Susan Straka; Changyu Shen; Thomas H Everett; Peng-Sheng Chen Journal: JCI Insight Date: 2019-02-21