From the Krannert Institute of Cardiology, Indiana University School of
Medicine, and the Roudebush Veterans Administration Medical Center,
Indianapolis, Ind. Dr Chiou is now at the National Yang-Ming University,
School of Medicine, and Veterans General Hospital, Taiwan.
Correspondence to Douglas P. Zipes, MD, Krannert Institute of Cardiology, 1111 W 10th St, Indianapolis, IN 46202-4800.
Background—The purpose of this study
was to test whether radiofrequency catheter ablation (RFCA) of 3
epicardial fat pads that resulted in efferent vagal denervation of the
atria and sinus and atrioventricular nodes also
denervated the ventricles.
Methods and Results—Vagal innervation of the ventricles was
determined by measuring prolongation of ventricular
effective refractory period induced by bilateral vagal stimulation (20
Hz, 10 V, 4 ms). Changes in heart rate variability (HRV) and baroreflex
sensitivity (BRS) were also examined. We found that RFCA of the 3
epicardial fat pads vagally denervated the sinus and AV nodes and atria
without affecting vagal innervation of the ventricles, indicating that
efferent vagal fibers to the ventricles do not travel through the 3
epicardial fat pads. Parameters of time-domain
variables decreased significantly; the total-power, high-frequency,
and low-frequency components of frequency-domain variables
decreased significantly; and the ratio of the low- and high-frequency
components increased significantly after chronic vagal denervation.
Vagally modulated sinus arrhythmia and BRS were also eliminated
after chronic vagal denervation. These data also indicate that HRV and
BRS represent vagal activity at the level of the sinus node and
may not accurately reflect efferent vagal activity at the
ventricular level.
Conclusions—Selective vagal denervation of the sinus and AV nodes
and atria decreased HRV and eliminated BRS while preserving
ventricular innervation.
© 1998 American Heart Association, Inc.
Basic Science Reports
Selective Vagal Denervation of the Atria Eliminates Heart Rate Variability and Baroreflex Sensitivity While Preserving Ventricular Innervation
Key Words: vagus nerve • heart rate • reflex
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