Doytchinova, AnisiiaHassel, Jonathan L.Yuan, YuanLin, HongboYin, DechunAdams, DavidStraka, SusanWright, KeithSmith, KimberlyWagner, DavidShen, ChangyuSalanova, VicentaMeshberger, ChadChen, Lan S.Kincaid, John C.Coffey, ArthurWu, GangLi, YanKovacs, Richard J.Everett, Thomas H., IVVictor, RonaldCha, Yong-MeiLin, Shien-FongChen, Peng-Sheng2018-05-252018-05-252017-01Doytchinova, A., Hassel, J. L., Yuan, Y., Lin, H., Yin, D., Adams, D., … Chen, P.-S. (2017). Simultaneous non-Invasive Recording of Skin Sympathetic Nerve Activity and Electrocardiogram. Heart Rhythm, 14(1), 25–33. http://doi.org/10.1016/j.hrthm.2016.09.019https://hdl.handle.net/1805/16253BACKGROUND: Sympathetic nerve activity is important to cardiac arrhythmogenesis. OBJECTIVE: The purpose of this study was to develop a method for simultaneous noninvasive recording of skin sympathetic nerve activity (SKNA) and electrocardiogram (ECG) using conventional ECG electrodes. This method (neuECG) can be used to adequately estimate sympathetic tone. METHODS: We recorded neuECG signals from the skin of 56 human subjects. The signals were low-pass filtered to show the ECG and high-pass filtered to show nerve activity. Protocol 1 included 12 healthy volunteers who underwent cold water pressor test and Valsalva maneuver. Protocol 2 included 19 inpatients with epilepsy but without known heart diseases monitored for 24 hours. Protocol 3 included 22 patients admitted with electrical storm and monitored for 39.0 ± 28.2 hours. Protocol 4 included 3 patients who underwent bilateral stellate ganglion blockade with lidocaine injection. RESULTS: In patients without heart diseases, spontaneous nerve discharges were frequently observed at baseline and were associated with heart rate acceleration. SKNA recorded from chest leads (V1-V6) during cold water pressor test and Valsalva maneuver (protocol 1) was invariably higher than during baseline and recovery periods (P < .001). In protocol 2, the average SKNA correlated with heart rate acceleration (r = 0.73 ± 0.14, P < .05) and shortening of QT interval (P < .001). Among 146 spontaneous ventricular tachycardia episodes recorded in 9 patients of protocol 3, 106 episodes (73%) were preceded by SKNA within 30 seconds of onset. Protocol 4 showed that bilateral stellate ganglia blockade by lidocaine inhibited SKNA. CONCLUSION: SKNA is detectable using conventional ECG electrodes in humans and may be useful in estimating sympathetic tone.en-USPublisher PolicyCold water pressor testMicroneurographySympathetic nerve activityVentricular tachycardiaArticle