Catheter Ablation -> Ventricular Arrhythmias -> Experimental methods D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-090 - Late Augmentations Of Skin Sympathetic Nerve Activity Indicatea A Favorable Outcome Following Catheter Ablation Of Right Ventricular Outflow Tract In Ventricular Arrhythmias (ID 658)


Background: Sympathetic nerves are densely innervated in right ventricular outflow tract (RVOT) and pulmonary trunk. The neuromodulation effect after ablation is unclear.
Objective: The study aimed to investigate the changes of skin sympathetic nerve activity (SKNA) in patients receiving catheter ablations involving RVOT.
Methods: Of 13 patients with drug-refractory symptomatic ventricular arrhythmias (9 idiopathic RVOT and 2 LV summit VPCs, 2 Brugada syndromes) receiving ablation (involving RVOT), SKNA was continuously recorded for 10 min during resting from ECG lead I configuration (ECG-SKNA) and bipolar electrodes on right arm (EMG-SKNA) 1-day before, after and 3 months after ablation.
Results: All patients (48±14 y/o, 6 males) received ablation in index procedure (6 recurrences after 20±5 months follow-ups). Before ablation, there were intermittent surges of SKNA (sSKNA) and associated with VPC initiation. There were no differences of average SKNA compared between before & 1-day after ablation, but sSKNAs were not associated with VPC initiation (Table). Those with late recurrence had a higher average SKNA 1 day after ablation, compared to those without recurrence. 6 months after ablation, those without recurrence had a higher average SKNA, compared to before ablation (within group), and to those with recurrence (between groups), respectively.
Conclusion: Transient augmentation of sympathetic activity immediately after RVOT ablation may indicate an inadequate neuromodulation with poor outcome, whereas post-procedural late augmentation of sympathetic activity represents a favorable outcome, suggesting a complete neuroablation with regenerated nerve sprouting.