Effects Of Resecting The Inferior Left Stellate Ganglion On Persistent Atrial Fibrillation

Atrial fibrillation(AF)is one of the common arrhythmias,the mechanisms of which have not been completely clarified yet and the therapeutic strategies of which are still controversial.A great quantity of researches suggested that autonomic nervous system(ANS)played an important role in AF development.Among them,stellate ganglion(SG)is a major source of cardiac sympathetic innervation,and stellate ganglion nerve activity(SGNA)is closely related to the genesis and perpetuation of AF.The purpose of the present study was to investigate the effects of selectively resecting the inferior left stellate ganglion(LSG)on ventricular rate(VR),atrial structural and neural remodeling in canines with sustained AF and to study the sympathetic innervation of SG on the heart.Furthermore,we aimed to explore the feasibility of selective resection of inferior LSG to control sustained AF and optimize the surgical treatment strategies of AF.This study mainly consists of the following 3parts:(1)To test the feasibility of using animal model in the study of persistent AF by inducing sustained canine AF model via continuous left atrial tachypacing(LAP).(2)To figure out the influences of selective resection of inferior LSG on VR in canines with sustained AF and explore the regulatory mechanism of LSG in controlling rapid VR during persistent AF.(3)To study the effects of selective resection of inferior LSG on cardiac sympathetic and atrial structural remodeling in canines with sustained AF and explore the relationship between cardiac sympathetic innervation and the perpetuation of persistent AF.From this study,we concluded that:(1)It is an effective way to induce sustained AF models in pups and adult dogs by continuous LAP.The diversity of VR variation between two groups indicated that adult dogs are more suitable to develop sustained AF models and to perform relative researches.(2)Resection of inferior LSG could help to reduce rapid VR during sustained AF,possible mechanisms of which are reducing the cardiac sympathetic innervation and prolonging the AVN forward passing ERP of AF canine.(3)Resection of inferior LSG could significantly decrease density of sympathetic nerve in bilateral SG and left atrium,attenuate left atrial fibrosis during AF,and thus inhibit the perpetuation of sustained AF.