To the Editor—Sympathetic innervation of the anterior left ventricular wall by the right and left stellate ganglia

We read with interest the recent publication by Vaseghi et al, 1 Vaseghi M. Zhou W. Shi J. et al. Sympathetic innervation of the anterior left ventricular wall by the right and left stellate ganglia. Heart Rhythm. 2012; 9: 1303-1309 Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar who investigated the effects of unilateral stellate ganglion stimulation in the pig heart, especially activation recovery intervals (ARIs) of the left ventricular (LV) anterior surface. Although the results from this technically challenging study are interesting, we would like to bring attention a number of methodological considerations that have implications on the interpretation and conclusions of the study. Sympathetic innervation of the anterior left ventricular wall by the right and left stellate gangliaHeart RhythmVol. 9Issue 8PreviewThe sympathetic nervous system is thought to play a role in the genesis of ventricular tachyarrhythmias (VT). Left and added right cardiac sympathectomy have been shown to reduce the burden of arrhythmias in the setting of a VT storm. However, the contribution of the right stellate ganglion (RSG) and the left stellate ganglion (LSG) to the innervation of the anterior left ventricular (LV) wall is not well understood. Full-Text PDF Reply to the Editor—Sympathetic Innervation of the Anterior Left Ventricular Wall by the Right and Left Stellate GangliaHeart RhythmVol. 9Issue 11PreviewWe thank Dr Winter, Dr Brack, Dr Coote, and Dr Ng for their comments and interest in our recently published paper.1 We agree that heart rate clearly has an effect on repolarization. The fact that right stellate ganglia (RSG) increases heart rate is a known physiologic phenomenon. Therefore, when assessing for dispersion, adjusting for heart rate is indeed nonphysiologic. This is clinically relevant in patients undergoing left and/or right cervicothoracic sympathectomy. Previous studies have also reported that adjusting for heart rate by pacing can alter autonomic tone. Full-Text PDF