SKNA recordings during the cold water pressor test (CPT) in healthy volunteers. The electrode location was on the right and left arm for ECG Lead I recording. A–D: Increased skin sympathetic nerve activity (SKNA) was detected in subjects 1–4, respectively, during the CPT. Black downward arrows point to increased SKNA prior to CPT, likely due to the anticipation of the impending cold water immersion. The increased SKNA was associated with heart rate acceleration in patients 1–3, but not in patient 4. Integrated SKNA (iSKNA) shows the total SKNA over 100 ms windows after applying 500 Hz high pass filter. HR= heart rate, bmp=beats per minute. (From Doytchinova et al, Heart Rhythm 2017)(47)