University of Twente Student Theses
Evaluation of the cardiac tone by sympathetic skin nerve activity
Tertoolen, J. (2023) Evaluation of the cardiac tone by sympathetic skin nerve activity.
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| Abstract: | A stellate ganglion blockade is a treatment to control Ventricular Arrhythmias. Clinical signs assess the outcomes of this treatment, but the outcomes are ambiguous without an obvious discriminator. Direct measurement of stellate ganglion nerve activity (SGNA) is a possibility to evaluate the blockade but requires invasive thoracotomy. A study by Doytchinova et al. reported a method to simultaneously record electrocardiogram (ECG) and sympathetic skin nerve activity (SKNA) using surface electrodes. This skin sympathetic nerve activity (SKNA) signal could be used to estimate the cardiac sympathetic tone. The primary goals of this explorative study are (1) to reproduce and optimize the measurement protocol and analysis algorithm for the SKNA data, and (2) to validate SKNA in a healthy population by correlating SKNA to heart rate variability and electrodermal activity while performing a provocative maneuver. Our hypothesis is that the SKNA and these sympathetic parameters are correlated. A pilot study is performed on six healthy subjects to develop the measurement protocol and analysis algorithm to extract the SKNA, EDA, and HRV parameters. The SKNA is recorded with three thorax- and three arm leads in another group of 41 healthy subjects. The influence of a Valsalva maneuver on the SKNA is determined and a correlation between the SKNA and other sympathetic activity parameters is investigated. In addition, an overview of the published articles regarding SKNA is generated. The arm leads are not suitable for ECG and HRV analysis. The integrated and averaged SKNA of the thorax leads have excellent correlation coefficients, whereas the SKNA of the arm leads is not correlated to the SKNA of the thorax leads. The method is able to identify a change in sympathetic activity. Although, poor correlations are found between the SKNA and other sympathetic markers. Based on the literature study, the SKNA is widely used and seems to be correlated to various parts of the ANS. Further research should investigate the SKNA in relation to patient-specific characteristics to establish normal values as a predictor for the outcome during SGB. The SKNA is widely used and seems to be correlated to various parts of the ANS. Further research should investigate the SKNA in relation to patient-specific characteristics to establish normal values as a predictor for the outcome during SGB. |
| Item Type: | Essay (Master) |
| Clients: | Medisch Spectrum Twente, Nederland |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/94185 |
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