Long-term intermittent high-amplitude subcutaneous nerve stimulation reduces sympathetic tone in ambulatory dogs

Yuan Yuan, Zhaolei Jiang, Ye Zhao, Wei Chung Tsai, Jheel Patel, Lan S. Chen, Changyu Shen, Shien-Fong Lin, Huei Sheng Vincent Chen, Thomas H. Everett, Michael C. Fishbein, Zhenhui Chen, Peng Sheng Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Reducing sympathetic efferent outflow from the stellate ganglia (SG) may be antiarrhythmic. Objective: The purpose of this study was to test the hypothesis that chronic thoracic subcutaneous nerve stimulation (ScNS) could reduce SG nerve activity (SGNA) and control paroxysmal atrial tachycardia (PAT). Methods: Thoracic ScNS was performed in 8 dogs while SGNA, vagal nerve activity (VNA), and subcutaneous nerve activity (ScNA) were monitored. An additional 3 dogs were used for sham stimulation as controls. Results: Xinshu ScNS and left lateral thoracic nerve ScNS reduced heart rate (HR). Xinshu ScNS at 3.5 mA for 2 weeks reduced mean average SGNA from 5.32 μV (95% confidence interval [CI] 3.89–6.75) at baseline to 3.24 μV (95% CI 2.16–4.31; P =.015) and mean HR from 89 bpm (95% CI 80–98) at baseline to 83 bpm (95% CI 76–90; P =.007). Bilateral SG showed regions of decreased tyrosine hydroxylase staining with increased terminal deoxynucleotidyl transferase dUTP nick-end labeling–positive nuclei in 18.47% (95% CI 9.68–46.62) of all ganglion cells, indicating cell death. Spontaneous PAT episodes were reduced from 9.83 per day (95% CI 5.77–13.89) in controls to 3.00 per day (95% CI 0.11–5.89) after ScNS (P =.027). Left lateral thoracic nerve ScNS also led to significant bilateral SG neuronal death and significantly reduced average SGNA and HR in dogs. Conclusion: ScNS at 2 different sites in the thorax led to SG cell death, reduced SGNA, and suppressed PAT in ambulatory dogs.

Original languageEnglish
Pages (from-to)451-459
Number of pages9
JournalHeart Rhythm
Issue number3
StatePublished - Mar 2018


  • Arrhythmia
  • Autonomic nervous system
  • Nerve Recording
  • Neuromodulation
  • Stellate ganglion

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