A one-stage, low mortality, surgical procedure for complete intrapericardial denervation of the dog heart is described. Examination of chronotropic, inotropic, and dromotropic influences of the autonomic cardiac nerves before and after the operation permits confirmation of the completeness of denervation. If after initial surgery residual responses remain, reexploration, further transection of tissue, and restimulation can be implemented until total denervation is accomplished. Attention is focused upon the characteristic shifts in the P wave and alterations in the T wave of the ECG during stimulation of the left sympathetics reflecting pacemaker and repolarization changes. Application of the technique results in a heart devoid of direct or reflex neural influences in the chronic animal model without using pharmacologic depleting compounds with untoward side effects.
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