Neurotoxic denervation of the left atrium for atrial fibrillation treatment and prevention: an experimental animal study

Objective. The key element of the onset and progression of atrial fibrillation is an autonomic nervous system. The aim of this study was to assess the electrophysiological efficacy and periprocedural safety of Type A botulinum toxin, the preparation that safely blocks the conduction without any serious complications. Methods. 30 mini pigs (weight 15-20 kg), were randomized into two groups. The first group (n = 15) received botulinum toxin injected in the projection of ANS ganglion plexus of the left atrium, while 0.9% sodium chloride solution was administered in the same zones of animals of the second (control) group (n = 15). Electrophysiological examination of the left atrium and procedure safety was carried out at baseline and 7, 14, 21, 30 days of follow-up. Results. 24 (80%) out of 30 animals survived. All exclusions were not related with the injection procedure. No significant complications, vital functional disorders, a decrease in left ventricular ejection fraction or a high level of cardiac toxic markers were observed in both groups. Starting from 7 to 30 days after the procedure we observed the statistically significant difference between the left atrium effective refractory period of the botulinum toxin and control group (12.4±3.5% versus 31.2±5.6%, p