Application of vagus nerve stimulation from the onset of ventricular fibrillation to post-shock period improves defibrillation efficacy

Thunsiri, Kittiya; Shinlapawittayatorn, Krekwit; Chinda, Kreokkiat; Palee, Siripong; Surinkaew, Sirirat; KenKnight, Bruce H.; Chattipakorn, Nipon

doi:10.1016/j.ijcard.2014.07.302

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…A study showed that VNS applied after the onset of VF improved defibrillation efficacy by decreasing the defibrillation threshold. [16] LVNS and RVNS have similar effects on ventricular activation recovery interval. [17] Both the right and left vagus nerves anatomically emit substantial projections to all chambers of the heart and are mediated by multiple ganglionated plexuses of the intrinsic cardiac nervous system (ICNS).…”

Section: Discussionmentioning

confidence: 80%

Left-sided vagus nerve stimulation improves cardiopulmonary resuscitation outcomes in rats as effectively as right-sided vagus nerve stimulation

Shao

Shu

et al. 2021

World Journal of Emergency Medicine

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BACKGROUND: Our group previously reported that right-sided vagus nerve stimulation (RVNS) signifi cantly improved outcomes after cardiopulmonary resuscitation (CPR) in a rat model of cardiac arrest (CA). However, whether left-sided vagus nerve stimulation (LVNS) could achieve the same eff ect as RVNS in CPR outcomes remains unknown.METHODS: A rat model of CA was established using modified percutaneous epicardial electrical stimulation to induce ventricular fi brillation (VF). Rats were treated with LVNS or RVNS for 30 minutes before the induction of VF. All animals were observed closely within 72 hours after return of spontaneous circulation (ROSC), and their health and behavior were evaluated every 24 hours. RESULTS: Compared with those in the RVNS group, the hemodynamic measurements in the LVNS group decreased more notably. Vagus nerve stimulation (VNS) decreased the serum levels of tumor necrosis factor-alpha (TNF-α) and the arrhythmia score, and attenuated inflammatory infiltration in myocardial tissue after ROSC, regardless of the side of stimulation, compared with fi ndings in the CPR group. Both LVNS and RVNS ameliorated myocardial function and increased the expression of α-7 nicotinic acetylcholine receptor in the myocardium after ROSC. Moreover, a clear improvement in 72-hour survival was shown with VNS pre-treatment, with no signifi cant diff erence in effi cacy when comparing the laterality of stimulation.CONCLUSIONS: LVNS may have similar eff ects as RVNS on improving outcomes after CPR.

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Section: Discussionmentioning

confidence: 80%

Left-sided vagus nerve stimulation improves cardiopulmonary resuscitation outcomes in rats as effectively as right-sided vagus nerve stimulation

Shao

Shu

et al. 2021

World Journal of Emergency Medicine

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“…Additionally, VNS reverses hypersympathetic nerve activity‐induced ventricular electrophysiological changes (i.e., progressive and significant decreases in VERPs and action potential durations APDs) and increases in the spatial dERP, maximal slope of the restitution curve, and pacing CL of the APD alternans . Thunsiri et al . reported the roles of VNS in improving defibrillation efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…Thunsiri et al15 reported the roles of VNS in improving defibrillation efficacy. VNS contributes to the prolongation of the P-R and R-R intervals, as well as the reduction of the defibrillation threshold.…”

mentioning

confidence: 99%

Vagus nerve stimulation reduces ventricular arrhythmias and increases ventricular electrical stability

Nasi-Er

Zhang

Sun

et al. 2019

Pacing Clinical Electrophis

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Background Transcutaneous stimulation of the auricular branch of the vagus nerve (AB‐VNS) is a potentially noninvasive, inexpensive, and safe approach for vagus nerve stimulation that suppresses the induction and duration of atrial fibrillation and reduces sympathetic nerve outflow in healthy humans. Researchers have not determined whether AB‐VNS affects ventricular arrhythmias. Objective To evaluate the antiarrhythmic effects of noninvasive AB‐VNS on ventricular arrhythmias induced by myocardial infarction (MI). Methods and Results Twelve beagle dogs were randomly divided into the following two groups: a AB‐VNS group (coronary artery occlusion and noninvasive AB‐VNS) and a control group (coronary artery occlusion but without AB‐VNS). We examined spontaneous ventricular arrhythmias, ventricular electrophysiological properties, and cardiac function in conscious dogs. Morphology, fibrosis, and http://ultrastructures were also assessed. AB‐VNS significantly reduced the occurrence of spontaneous ventricular arrhythmias, including isolated premature ventricular complexes, ventricular couplets, ventricular bigeminy, ventricular trigeminy, and ventricular tachycardia. AB‐VNS effectively increased ventricular electrical stability, including significantly prolonged ventricular effective refractory periods, decreased the dispersion of effective refractory period, enhanced the ventricular fibrillation threshold, and decreased the maximum slope of the monophasic action potential duration restitution curve. AB‐VNS treatments alleviate ventricular interstitial fibrosis after MI. However, cardiac function was not improved, and MI‐induced ultrastructural changes in the myocardium were not reversed by 4 weeks of AB‐VNS. In addition, AB‐VNS for 4 weeks resulted in mild mitochondrial swelling within the neuronal axons of the auricular vagus fiber. Conclusions Noninvasive AB‐VNS reduces the occurrence of spontaneous ventricular arrhythmias in conscious dogs with MI. AB‐VNS increases ventricular electrical stability and alleviates ventricular interstitial fibrosis induced by MI.

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“…It has been found that gap junctional remodeling (connexin expression is downregulated and distributed) is closely associated with AF maintenance [1]. Autonomic nervous system stimulation can exert anti-arrhythmia effects [2,3]. Recently, we reported that cervical low level vagal nerve stimulation (LL-VNS) could suppress AF induced high-frequency stimulation [4] and then we developed a non-invasive approach, low level tragus nerve stimulation (LL-TS), and found that it had the same effect on suppressing AF [5].…”

mentioning

confidence: 99%

Low level tragus nerve stimulation is a non-invasive approach for anti-atrial fibrillation via preventing the loss of connexins

Chen

Liu

et al. 2015

International Journal of Cardiology

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Application of vagus nerve stimulation from the onset of ventricular fibrillation to post-shock period improves defibrillation efficacy

Cited by 7 publications

References 8 publications

Left-sided vagus nerve stimulation improves cardiopulmonary resuscitation outcomes in rats as effectively as right-sided vagus nerve stimulation

Left-sided vagus nerve stimulation improves cardiopulmonary resuscitation outcomes in rats as effectively as right-sided vagus nerve stimulation

Vagus nerve stimulation reduces ventricular arrhythmias and increases ventricular electrical stability

Low level tragus nerve stimulation is a non-invasive approach for anti-atrial fibrillation via preventing the loss of connexins

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