Experimental study on ventricular extrasystoles provoked by vagal stimulation

Scherf, David; Blumenfeld, Serge; Yildiz, Muhtar

doi:10.1016/0002-8703(61)90375-1

Cited by 26 publications

(10 citation statements)

References 17 publications

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“…Although VNS reduces ischemia-induced VF and VT, stimulation of the vagosympathetic trunk at high frequencies (>20 Hz) and at intensities that cause severe bradycardia or asystole can induce bigeminy [55–58] and monomorphic VT [15, 30, 55]. With high-intensity VNS in the setting of acute and chronic ischemia, monomorphic VT can be induced, which can degenerate into VF [22].…”

Section: Neural Modulation Of Ventricular Arrhythmias With Vnsmentioning

confidence: 99%

“…This phenomenon is eliminated when ventricle is paced faster than underlying ventricular escape rate [59]. The unmasking phenomenon of PVCs also carries over to VT [30, 55, 57]. Scherf et al in 1962 [55] showed that occurrence of ventricular couplets with VNS was more frequent when the sinus rhythm rate was lowered from 175 beats perminute (bpm) to less than 100 bpm in a canine model.…”

Section: Neural Modulation Of Ventricular Arrhythmias With Vnsmentioning

confidence: 99%

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Device-Based Autonomic Modulation in Arrhythmia Patients: the Role of Vagal Nerve Stimulation

Huang¹,

Shivkumar

Vaseghi

2015

Curr Treat Options Cardio Med

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Opinion statement Vagal nerve stimulation (VNS) has shown promise as an adjunctive therapy for management of cardiac arrhythmias by targeting the cardiac parasympathetic nervous system. VNS has been evaluated in the setting of ischemia-driven ventricular arrhythmias and atrial arrhythmias, as well as a treatment option for heart failure. As better understanding of the complexities of the cardiac autonomic nervous system is obtained, vagal nerve stimulation will likely become a powerful tool in the current cardiovascular therapeutic armamentarium.

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Section: Neural Modulation Of Ventricular Arrhythmias With Vnsmentioning

confidence: 99%

Section: Neural Modulation Of Ventricular Arrhythmias With Vnsmentioning

confidence: 99%

Device-Based Autonomic Modulation in Arrhythmia Patients: the Role of Vagal Nerve Stimulation

Huang¹,

Shivkumar

Vaseghi

2015

Curr Treat Options Cardio Med

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“…Einbrodt assessed the effects of an inductorium on heart beats and noticed that during vagal stimulation, the distance between the coils could be markedly reduced, thereby increasing the current delivered, before ventricular fibrillation (VF) occurred and the dog died [1]. Despite this pioneering observation, dating back to 1859, the dominant view [2][3][4], with few exceptions [5,6], was that vagal hyperactivity is proarrhythmic and favors the occurrence of VF. The proarrhythmic effect of vagal stimulation was not confirmed in dogs subjected to coronary artery occlusion by Scherlag et al [7] and by Kerzner et al [8]and was seriously questioned in the early 1970s [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Vagus nerve stimulation: from pre-clinical to clinical application: challenges and future directions

2010

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Vagus nerve stimulation was performed experimentally for the first time more than 150 years ago. In the 1980s and 1990s, vagus nerve stimulation was shown, both in the anesthetized and in the conscious animal, to exert marked antiarrhythmic effects, particularly during acute myocardial ischemia. There is a strong rationale for a beneficial effect of augmented vagal activity in the setting of chronic heart failure. Studies in experimental models of heart failure showed that chronic vagus nerve stimulation exerts beneficial effects on left ventricular function and on survival. Vagus nerve stimulation is approved in man for refractory epilepsy and depression. The first-in-man study performed in 32 patients with chronic heart failure suggests that vagus nerve stimulation was safe and well tolerated. Six months of open-label treatment was associated with significant improvements (P < 0.001) in NYHA class, quality of life, 6-min walk test, LV ejection fraction (from 22 ± 7 to 29 ± 8%), and LV systolic volumes (P = 0.02). These improvements were maintained at 1 year. Mechanisms of action may include the following: heart rate, anti-adrenergic, anti-apoptotic, and anti-inflammatory effects as well as an increase in nitric oxide. Controlled clinical trials will start soon to assess whether vagus nerve stimulation can indeed represent a new non-pharmacological approach for the treatment of symptomatic heart failure.

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“…A lower degree of cholinergic activation appears to be arrhythmogenic (16,17) and to increase the frequency of ventricular presystolic contractions particularly in the presence of high cardiac adrenergic activity.…”

Section: Discussionmentioning

confidence: 98%

The influence of cardiac cholinergic activation on the induction and maintenace of ventricular fibrillation

1984

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The influence of cardiac cholinergic activation was studied in rats and cats on the induction and maintenance of ventricular fibrillation (VF). Acetylcholine (ACH 2-25 micrograms/kg), in doses which did not cause bradycardia or hypotension, induced appearance of spontaneous VF (duration 2-60 sec.) in 9/20 rats which have a high sympathetic autoregulation and in 3/6 cats only, 20-40 secs after the latter had been given adrenaline. ACh (10-45 micrograms/kg) and methacholine (10-40 micrograms/kg) also significantly prolonged the fibrillatory period induced electrically in cats and rats with and without atrial or ventricular pacing. The induction or prolongation of VF did not occur when higher doses of ACh (50-100 micrograms/kg) were given to rats. The influence of moderate amounts of cholinergic agents on the heart may be due to localised effects resulting in asynchronous activity. Alternatively, they may produce a discharge of multiple ectopic pacemakers or a disturbance in impulse conduction. Higher doses of ACh depress the S-A and ventricular ectopic activity node thereby decreasing the probability of inducing VF. It is concluded that under conditions of raised cardiac adrenergic activity, a moderate increase in cholinergic influence can both induce and prolong VF. The relevance of these findings to the "sudden infant death" syndrome is discussed.

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Experimental study on ventricular extrasystoles provoked by vagal stimulation

Cited by 26 publications

References 17 publications

Device-Based Autonomic Modulation in Arrhythmia Patients: the Role of Vagal Nerve Stimulation

Device-Based Autonomic Modulation in Arrhythmia Patients: the Role of Vagal Nerve Stimulation

Vagus nerve stimulation: from pre-clinical to clinical application: challenges and future directions

The influence of cardiac cholinergic activation on the induction and maintenace of ventricular fibrillation

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