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Tung R, Shivkumar K. Neuraxial modulation for treatment of VT storm. J Biomed Res. 2014;29(1):56-60doi: 10.7555/JBR.29.20140161.
Tung, R., & Shivkumar, K. (2015). Neuraxial modulation for treatment of VT storm. Journal of biomedical research, 29(1), 56-60. https://doi.org/10.7555/JBR.29.20140161
Tung, Roderick, and Shivkumar, Kalyanam. "Neuraxial modulation for treatment of VT storm." Journal of biomedical research vol. 29,1 (2015): 56-60. doi: https://doi.org/10.7555/JBR.29.20140161
Tung R, Shivkumar K. Neuraxial modulation for treatment of VT storm. J Biomed Res. 2015 Jan;29(1):56-60. doi: 10.7555/JBR.29.20140161. Epub 2014 Dec 28. PMID: 25745476; PMCID: PMC4342436.
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J Biomed Res. 2015 Jan;29(1):56-60. doi: 10.7555/JBR.29.20140161. Epub 2014 Dec 28.

Neuraxial modulation for treatment of VT storm.

Journal of biomedical research

Roderick Tung, Kalyanam Shivkumar

Affiliations

  1. UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1679, USA.

PMID: 25745476 PMCID: PMC4342436 DOI: 10.7555/JBR.29.20140161

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.

Keywords: autonomic; denervation; neuraxial; tachycardia; ventricular

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