Neuraxial modulation for treatment of VT storm

Roderick Tung, Kalyanam Shivkumar

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

In the hyperadrenergic state of VT storm where shocks are psychologically and physiologically traumatizing, suppression of sympathetic outflow from the organ level of the heart up to higher braincenters plays a significant role in reducing the propensity for VT recurrence. The autonomic nervous system continuously receives input from the heart (afferent signaling), integrates them, and sends efferent signals to modify or maintain cardiac function and arrhythmogenesis. Spinal anesthesia with thoracic epidural infusion of bupivicaine and surgical removal of the sympathetic chain including the stellate ganglion has been shown to decrease recurrences of VT. Excess sympathetic outflow with catecholamine release can be modified with catheter-based renal denervation. The insights provided from animal experiments and in patients that are refractory to conventional therapy have significantly improved our working understanding of the heart as an end organ in the autonomic nervous system.

Original languageEnglish (US)
Pages (from-to)56-60
Number of pages5
JournalJournal of Biomedical Research
Volume29
Issue number1
DOIs
StatePublished - 2015
Externally publishedYes

Keywords

  • Autonomic
  • Denervation
  • Neuraxial
  • Tachycardia
  • Ventricular

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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