Denervation and Reinnervation versus CNA
Cardiac innervation is highly primitive and exhibits a substantial capacity for reinnervation15,31. It is estimated that reinnervation may recover between 30% to 60% of the basal innervation. Consequently, the broader the initial procedure, the greater the potential for long-term success32.
In this study, we observed that the electrophysiological parameters of denervation were equally achieved in both groups. There is no doubt that both techniques induced significant acute denervation. However, it became evident that there was indeed a difference in the extent of denervation and in preventing reinnervation. This conclusion is supported by the fact that in the NoECVS group, the risk of relapse was five times higher with a high level of statistical significance. Moreover, relapses occurring between 10 and 25 months in this group suggest reinnervation. This finding is crucial because we may observe an initial apparent denervation response, likely due to superficial effects, without the elimination of deep GPs and micro-GPs. Naturally, the absence of more extensive elimination of these GPs may facilitate reinnervation and significantly increase the likelihood of relapse.