Neuraxial modulation for treatment of VT storm

Journal of Biomedical Research
Roderick Tung, Kalyanam Shivkumar

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.

Citations

Dec 12, 2019·Pacing and Clinical Electrophysiology : PACE·Perry Wu, Marmar Vaseghi
Mar 20, 2019·Current Cardiology Reports·Veronica DusiOlujimi A Ajijola
Nov 9, 2018·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Supriya D'souzaManju Butani

❮ Previous
Next ❯

Methods Mentioned

BETA
sedation

Related Concepts

Related Feeds

Cardiac Regeneration

Cardiac regeneration enables the repair of irreversibly damaged heart tissue using cutting-edge science, including stem cell and cell-free therapy. Discover the latest research on cardiac regeneration here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

© 2022 Meta ULC. All rights reserved