Stellate Ganglia

Most cardiac sympathetic innervation arises from the stellate ganglia, which form by fusion of the lower cervical and first thoracic sympathetic ganglia. In vivo stellate ganglion stimulation lowers the fibrillatory threshold and induces ventricular arrhythmia. Stellate ganglion stimulation increases the T-peak to T-end interval, an independent ECG predictor of sudden cardiac death risk. Stellate ganglia removed from patients with recurrent ventricular arrhythmias show structural and immune changes including larger neurons, increased synaptic density, oxidative stress, and T-cell infiltration. Stellate ganglion glial activation in mice increases sympathetic output to the heart, heart rate, myocardial contraction, and cardiac norepinephrine release.