Ventricular rate control using a novel vagus nerve stimulating system in a dog with chronic atrial fibrillation

Ohad, Dan G.; Sinai, Yitzhak Brzezinski; Zaretsky, Asaph; Shofti, Rona

doi:10.1016/j.jvc.2008.09.004

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…Importantly, AVN-VS therapy was well tolerated by conscious animals, causing no signs of distress or discomfort. In fact, successful veterinarian use of (cervical) VNS with an implanted device to control ventricular rate has been reported in a dog with AF [110]. In addition to the epicardial fat pad stimulation, selective AVN-VS has also been achieved through the endocardial approach.…”

Section: Termination Of Paroxysmal Supraventricular Tachycardia By Vamentioning

confidence: 99%

Arrhythmias and vagus nerve stimulation

Zhang

Mazgalev

2010

Heart Fail Rev

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Enhancing vagal tone by delivering electrical stimulation to the vagal nerves (VNS) is emerging as a promising novel therapy in heart failure. In addition, VNS is already an FDA-approved therapy for refractory epilepsy and depression. Besides its well-known negative chronotropic, inotropic, and dromotropic effects, VNS has profound effects on cardiac electrophysiology and arrhythmogenesis. This review summarizes current knowledge about the complex relationship between VNS and cardiac arrhythmias. Specifically, the focus is on VNS capability to become a therapeutic strategy along with important electrophysiological alterations that may constitute a potential arrhythmogenic substrate and become a clinical concern.

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Section: Termination Of Paroxysmal Supraventricular Tachycardia By Vamentioning

confidence: 99%

Arrhythmias and vagus nerve stimulation

Zhang

Mazgalev

2010

Heart Fail Rev

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“…sustained, rapid and irregular ventricular rates secondary to supraventricular tachyarrhythmias such as atrial fibrillation. This can lead to adverse structural cardiac remodelling and development of tachycardia‐induced cardiomyopathy (Ohad and others 2008).…”

Section: Introductionmentioning

confidence: 99%

“…subaortic stenosis) and acquired (e.g. dilated cardiomyopathy) heart diseases (Hollmer and others 2008, Borgarelli and others 2006, Koch and others 1996, Martin and others 2009, O’Grady and O’Sullivan 2004, Ohad and others 2008).…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic values in clinically healthy adult dogue de Bordeaux dogs

Locatelli¹,

Santini²,

Bonometti³

et al. 2011

Journal of Small Animal Practice

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The echocardiographic parameters related to body surface area, in the absence of correlation with other independent variables (gender and age) should be interpreted with caution because their variation could be significant for the presence of heart disease. The proposed statistical model allows estimation of echocardiographic parameters in dogue de Bordeaux dogs with different body surface areas and ages.

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“…Short‐term endocardial cholinergic stimulation combined with left ventricular pacing also improved ventricular function in a patient who suffered from refractory AF with a rapid ventricular rate and cardiogenic shock 10 . Interestingly, long‐term cervical vagal stimulation was utilized to achieve rate control for more than 9 months in a family dog with refractory AF and heart failure 11 . Despite this great progress, remaining obstacles have so far prevented the use of neurostimulation for long‐term ventricular rate control.…”

Section: Need For Alternative Rate Control Therapiesmentioning

confidence: 99%

Imminent Ganglionic Ventricular Rate Control During Atrial Fibrillation

Billette

Tadros

2010

Cardiovasc electrophysiol

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Editorial CommentThe treatment of atrial fibrillation (AF), a well-known major clinical burden, mainly involves one of two approaches, rhythm or rate control. The first approach aims at reestablishing and maintaining sinus rhythm. The second approach applies to a majority of patients and aims at slowing the ventricular rate to a hemodynamically optimal level. As supported by abundant data, rate control is largely equivalent to rhythm control in terms of mortality and cardiovascular morbidity, 1 even in systolic heart failure patients. 2 The present comment concerns the long-term clinical applicability of the developing strategy of ganglionic rate control. Need for Alternative Rate Control TherapiesAs summarized in a comprehensive review, 3 different strategies are used or are currently being assessed to control the ventricular rate during AF. The primary strategy relies on negative dromotropic agents that impair atrioventricular node (AVN) function to a level achieving a suitable ventricular rate. However, contraindications, side effects, or inadequate rate control with these agents are frequently encountered in clinical practice. With failure of pharmacological rate control, a current strategy consists of AVN ablation combined with right ventricular or biventricular pacing. The obvious disadvantages of such an approach are the permanent nature of AVN ablation and pacemaker dependence. This approach also carries a risk of sudden death and of detrimental hemodynamic effects due to an abnormal ventricular activation sequence. 4 Biventricular pacing may obviate to this difficulty particularly in patients with systolic heart failure. 5 Another strategy under investigation is based on selective slow and/or fast AVN pathway ablation that may slow the ventricular rate while avoiding pacemaker implantation. However, this approach suffers from an inconsistent efficacy, frequent return to rapid ventricular rate, and inherent risk of thirddegree AVN block. 4 Another approach involves ablation of AVN inputs that spares the junctional pacemaker site and thus avoids dependence on a pacemaker device. 6 This approach still has a limited success rate and awaits formal validation. Two other futuristic rate control strategies have been developed. Gene therapy involving inhibitory G protein overexpression in AVN cells slows ventricular rate during AF in swine hearts. 7 TGFβ-treated autologous fibroblasts injected in AVN region also slow ventricular rate during AF in dogs. 8 These last two biological approaches still remain empirical.Closer to clinical applicability is the strategy tailored to decrease ventricular rate during AF by impairing AVN function through parasympathetic stimulation. Over the last decade, different approaches were developed to stimulate the right inferior ganglionic plexus (RIGP) that selectively innervates the AVN and thus constitutes a potential target to control the ventricular rate during AF. This development has already gone through several successful steps and now stands as a promising rate control thera...

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Ventricular rate control using a novel vagus nerve stimulating system in a dog with chronic atrial fibrillation

Cited by 7 publications

References 29 publications

Arrhythmias and vagus nerve stimulation

Arrhythmias and vagus nerve stimulation

Echocardiographic values in clinically healthy adult dogue de Bordeaux dogs

Imminent Ganglionic Ventricular Rate Control During Atrial Fibrillation

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