Arrhythmias & electrophysiology
Left Stellate Ganglion Pulsed Radiofrequency Suppresses Ischemic Ventricular Arrhythmias: A Translational Study
Authors' conclusion
LSG-PRF is a minimally invasive neuromodulatory strategy associated with suppression of sympathetic hyperactivity and post-MI VAs, accompanied by attenuated ganglionic inflammation and modulated cardiac neuro-immune signaling. Preliminary clinical experience supports feasibility and warrants prospective trials.
Study context
- Population
- Healthy rats, rats with myocardial infarction, and patients with drug-refractory electrical stormrats in two experiments plus 4 patients · Healthy rats (safety) 15 · myocardial infarction (MI) model rats 24 · Patients with drug-refractory electrical storm 4
- Exposure
- Pulsed radiofrequency (PRF) of the left stellate ganglion (LSG) vs control or surgical LSG excision (safety), and MI + PRF vs MI and Sham
- Outcome
- Cardiac sympathetic nerve activity, VT/VF inducibility and duration on programmed stimulation, serum norepinephrine and angiotensin II, left ventricular function, myocardial fibrosis
Methodological detailsrandomized (healthy rats), rat myocardial infarction model, bulk RNA-seq and single-cell RNA-seq, ultrasound-guided LSG-PRF in patients
- Randomized (healthy rats)
- Rat myocardial infarction model
- Bulk RNA-seq and single-cell RNA-seq
- Ultrasound-guided LSG-PRF in patients
Main finding
As reported in the abstract
- In MI rats, PRF reduced cardiac sympathetic nerve activity, attenuated VT/VF inducibility and duration, lowered serum norepinephrine and angiotensin II, improved left ventricular function, and reduced myocardial fibrosis
Observational data: associations, not effects.
Further findings
Sustained ventricular tachycardia recurrence in patients · median follow-up of 12 months
- No sustained ventricular tachycardia recurrence in all 4 patients
LSG transcriptomics
- Down-regulation of inflammation- and sprouting-related genes including S100a9 and Ngf
Single-cell analysis of the infarcted heart
- Attenuation of a proinflammatory Grik2+ Schwann cell subset, with computationally inferred reductions in neuro-immune signaling
Safety
Horner's syndrome and hypotension (healthy rats)
- In contrast to LSG excision, PRF produced only transient Horner's syndrome and did not cause hypotension
Original publication
Left Stellate Ganglion Pulsed Radiofrequency Suppresses Ischemic Ventricular Arrhythmias: A Translational Study. JACC Clin Electrophysiol. Published 18 September 2026. doi:10.
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