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Stimulation Mapping of the Pulmonary Artery for Denervation Procedures: an Experimental Study

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Abstract

Transcatheter pulmonary artery denervation (PADN) has been developed for the correction of pulmonary hypertension. We investigated pulmonary artery stimulation mapping and its role in PADN procedures. Artery stimulation was performed in 17 Landrace pigs. Low-frequency stimulation defined areas of ventricular and atrial capture. High-frequency stimulation evoked the following responses: sinus rhythm slowing and/or atrial rhythm acceleration in 59% of animals, phrenic nerve capture in 100%, and laryngeal recurrent nerve capture in 23%. The sites with evoked heart rate responses were marked by discrete radiofrequency ablations (RFA). An autopsy showed nerves in the adventitia and perivascular fat under the RFA sites, and the lack of muscarinic-1, tyrosine hydroxylase, and dopamine-5 receptors’ expression. During PADN, areas adjacent to the course of phrenic and recurrent laryngeal nerves should be avoided. RFA at points with heart rate responses leads to the non-reproducibility of evoked reactions and the disappearance of neural markers’ expression.

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Abbreviations

CVP:

Central venous pressure

HFS:

High-frequency stimulation

ISABP:

Invasive systemic arterial blood pressure

LFS:

Low-frequency stimulation

mPAP:

Mean pulmonary artery pressure

PA:

Pulmonary artery

PADN:

Pulmonary artery denervation

PAH:

Pulmonary arterial hypertension

PAP:

Pulmonary artery pressure

RFA:

Radiofrequency ablation

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Acknowledgments

The authors thank Lada A. Murashova, VMD, and Stepan E. Voronin, VMD, for their technical assistance and support in experiment organization.

Funding

The study has been supported by the grant from the Ministry of Science and Higher Education of the Russian Federation (agreement #075-15-2020-800). The funding authority had no impact on the study design nor in the interpretation of the results.

Author information

Authors and Affiliations

  1. Neuromodulation Laboratory, Almazov National Medical Research Centre, 197341, Akkuratova st.2, Saint Petersburg, Russian Federation

    Heber Ivan Condori Leandro, Aleksandr D. Vakhrushev & Evgeny N. Mikhaylov

  2. Non-coronary Heart Disease Department, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation

    Natalia S. Goncharova & Olga M. Moiseeva

  3. Pavlov First Saint Petersburg Medical University, Saint Petersburg, Russian Federation

    Lev E. Korobchenko & Elizaveta M. Andreeva

  4. Pathology Department, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation

    Elena G. Koshevaya & Lubov B. Mitrofanova

  5. Arrhythmia Department, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation

    Dmitry S. Lebedev & Evgeny N. Mikhaylov

  6. Department of Bioengineering Systems, Saint Petersburg Electrotechnical University “LETI”, Saint Petersburg, Russian Federation

    Dmitry S. Lebedev & Evgeny N. Mikhaylov

Authors
  1. Heber Ivan Condori Leandro
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  2. Aleksandr D. Vakhrushev
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  3. Natalia S. Goncharova
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  4. Lev E. Korobchenko
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  5. Elena G. Koshevaya
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  6. Lubov B. Mitrofanova
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  7. Elizaveta M. Andreeva
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  8. Olga M. Moiseeva
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  9. Dmitry S. Lebedev
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  10. Evgeny N. Mikhaylov
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Contributions

NSG, OMM, DSL, and ENM contributed to the study conception and design. Material preparation, data collection, and analysis were performed by HICL, ADV, NSG, LEK, EGK, LBM, EMA, and ENM. The first draft of the manuscript was written by HICL, ADV, NSG, and ENM, and all authors commented on the manuscript. All authors read and approved the final manuscript version.

Corresponding author

Correspondence to Evgeny N. Mikhaylov.

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Conflict of Interest

Author ENM has received speakers and consultation honoraria from Biosense Webster. The other authors declare that they have no conflicts of interest.

Ethical Approval

All institutional and national guidelines for the care and use of laboratory animals were followed and approved by the appropriate institutional committees.

Additional information

Associate Editor Marat Fudim oversaw the review of this article

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Condori Leandro, H., Vakhrushev, A.D., Goncharova, N.S. et al. Stimulation Mapping of the Pulmonary Artery for Denervation Procedures: an Experimental Study. J. of Cardiovasc. Trans. Res. 14, 546–555 (2021). https://doi.org/10.1007/s12265-020-10079-4

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  • DOI: https://doi.org/10.1007/s12265-020-10079-4

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