Arrhythmias & electrophysiologyCohort study
Left Stellate Ganglion Pulsed Radiofrequency Suppresses Ischemic Ventricular Arrhythmias
- Preclinical study in rats with a translational case series
- randomized (healthy rats)
- rat myocardial infarction model
- bulk RNA-seq and single-cell RNA-seq
- ultrasound-guided LSG-PRF in patients
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
Main finding
As reported in the abstract
Cardiac sympathetic nerve activity, VT/VF inducibility and duration on programmed stimulation, serum norepinephrine and angiotensin II, left ventricular function, myocardial fibrosis
- 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. JACC Clin Electrophysiol. Published 18 September 2026. doi:10.1016/j.jacep.2026.08.019
Summarised from the published abstract; every number is checked against it