Nerve sprouting induced by radiofrequency catheter ablation in dogs
Yuji Okuyama1, Hui-Nam Pak, Yasushi Miyauchi
1Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Objectives:
The purpose of this study was to test the hypothesis that radiofrequency (RF) catheter ablation results in cardiac nerve sprouting.
Background:
Nerve sprouting plays a role in cardiac arrhythmogenesis. Whether or not nerve sprouting occurs after RF catheter ablation is unclear.
Methods:
We performed RF catheter ablation in the right atrium (RA) and right ventricle (RV) in 10 dogs, which then were sacrificed in 2 hours (acute group, n = 5) or 1 month (chronic group, n = 5). Seven normal dogs were used as control. Immunohistochemical staining for growth-associated protein 43 (GAP-43) was performed to measure growing (sprouting) nerves.
Results:
A significant increase of GAP-43 immunoreactive nerve fiber density was observed at the RA ablation sites in 2 hours (4,410 +/- 1,379 microm(2)/mm(2)) and in 1 month (2,948 +/- 666 microm(2)/mm(2)) after ablation compared to controls (1,377 +/- 471 microm(2)/mm(2), P = .0001). At remote sites (>2 cm away from ablation sites) of RA, RF ablation also resulted in robust nerve sprouting in both the acute group (5,846 +/- 3241 microm(2)/mm(2)) and the chronic group (6,030 +/- 2226 microm(2)/mm(2)). RF ablation in the RV did not increase nerve density at the ablation sites, but nerve density was increased at remote sites in 2 hours (1,345 +/- 451 microm(2)/mm(2), P = .0136) that was reduced down to the normal control level (722 +/- 337 microm(2)/mm(2)) in 1 month.
Conclusions:
Nerve sprouting occurred within 2 hours after RF ablation in both the RA and RV and persisted for at least 1 month in the RA but not the RV. The increased GAP-43(+) nerve densities developed at both the ablation and the remote sites.
