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.