The autonomic neural mechanism of right ventricular outflow tract tachycardia

Hung Yu Chang, Li Wei Lo*, Yu Ruey Chen, Yu Hui Chou, Wei Lun Lin, Yenn Jiang Lin, Wei Hsian Yin, An Ning Feng, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Ventricular tachycardia (VT) and ventricular premature complexes (VPCs) originating from the right ventricular outflow tract (RVOT) are generally considered as benign arrhythmias, with ECG morphology showing LBBB pattern and inferior axis. Pathogenic mechanisms in the genesis of RVOT VT/VPC remain largely unknown. We aimed to investigate the neural mechanism in RVOT ventricular arrhythmias in canine model. Methods: Twelve mongrel dogs (13.7 ± 1.3 kg, 5 male dogs) were studied through midline thoracotomies. High-frequency stimulation (HFS) was applied to the proximal pulmonary artery (PA) to induce RVOT VT/VPC. An EnSite Array and a mapping catheter were used for electroanatomical mapping. The RVOT and PA were surgically excised for immunohistochemistry studies, including tyrosine hydroxylase (TH) stain for sympathetic nerves and choline acetyltransferase (ChAT) stain for parasympathetic nerves. Results: In nine (75%) out of twelve dogs, HFS of the proximal PA induced RVOT VT/VPC. The density of TH-positive nerves was significantly higher than that of ChAT-positive nerves (6803 ± 700 vs. 670 ± 252 μm 2 /mm 2 , p < 0.001). Furthermore, the density of TH-positive nerves was also significantly higher in the VT/VPC origin sites than that in the non-origin sites (18,044 ± 2866 vs. 5554 ± 565 μm 2 /mm 2 , p = 0.002). Catheter ablation of the proximal PA eliminated the inducibility of RVOT VT/VPC successfully. Conclusions: HFS of the proximal PA could induce RVOT VT/VPC. The sympathetic nerves were densely innervated to the origin of RVOT VT/VPC, indicating the critical role of sympathetic hyperactivity in the initiation and perpetuation of RVOT VT/VPC.

Original languageEnglish
Pages (from-to)10-16
Number of pages7
JournalAutonomic Neuroscience: Basic and Clinical
StatePublished - Jul 2018


  • Autonomic nervous system
  • High frequency stimulation
  • Right ventricular outflow tract
  • Sympathetic
  • Ventricular arrhythmia


Dive into the research topics of 'The autonomic neural mechanism of right ventricular outflow tract tachycardia'. Together they form a unique fingerprint.

Cite this