Heart Rhythm
Volume 6, Issue 2 , Pages 244-250 , February 2009

Relationship between right cervical vagus nerve stimulation and atrial fibrillation inducibility: Therapeutic intensities do not increase arrhythmogenesis

  • Youhua Zhang, MD, PhD

      Affiliations

    • Department of Molecular Cardiology, Cleveland Clinic, Cleveland, Ohio
    • ,
  • Itamar Ilsar, DVM

      Affiliations

    • Henry Ford Health System, Detroit, Michigan
    • ,
  • Hani N. Sabbah, PhD

      Affiliations

    • Henry Ford Health System, Detroit, Michigan
    • ,
  • Tamir Ben David, PhD

      Affiliations

    • BioControl Medical, Inc., Yehud, Israel
    • ,
  • Todor N. Mazgalev, PhD, FHRS

      Affiliations

    • Department of Molecular Cardiology, Cleveland Clinic, Cleveland, Ohio
    • Corresponding Author InformationAddress reprint requests and correspondence: Todor N. Mazgalev, Ph.D., Cleveland Clinic, Research Building NE61, 9500 Euclid Avenue, Cleveland, Ohio 44195

Received 7 October 2008 ,Accepted 29 October 2008.

References 

  1. Zhang Y, Mazgalev TN. Role of the vagus in AF: pathophysiology and therapeutic applications. In:  Natale A,  Jalife J editor. Atrial Fibrillation: From Bench to Bedside. Totowa, NJ: Humana Press; 2008;p. 115–131
  2. Andrus EC, Carter EP. The refractory period of the normally-beating dog's auricle; with a note on the occurrence of auricular fibrillation following a single stimulus. J Exp Med. 1930;51:357–368
  3. Schauerte P, Scherlag BJ, Pitha J, et al. Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation. Circulation. 2000;102:2774–2780
  4. Lemola K, Chartier D, Yeh YH, et al. Pulmonary vein region ablation in experimental vagal atrial fibrillation: role of pulmonary veins versus autonomic ganglia. Circulation. 2008;117:470–477
  5. Scherlag BJ, Nakagawa H, Jackman WM, et al. Electrical stimulation to identify neural elements on the heart: their role in atrial fibrillation. J Interv Card Electrophysiol. 2005;1(13):37–42
  6. Liu L, Nattel S. Differing sympathetic and vagal effects on atrial fibrillation in dogs: role of refractoriness heterogeneity. Am J Physiol. 1997;273:H805–H816
  7. Chiou CW, Eble JN, Zipes DP. Efferent vagal innervation of the canine atria and sinus and atrioventricular nodes (The third fat pad). Circulation. 1997;95:2573–2584
  8. Li M, Zheng C, Sato T, et al. Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats. Circulation. 2004;109:120–124
  9. Sabbah HN, Rastogi S, Mishra S, et al. Long-term therapy with neuroselective electric vagus nerve stimulation improves LV function and attenuates LV global remodeling in dogs with chronic heart failure (Abstract). Eur J Heart Failure. 2005;4:166–167
  10. Vanoli E, De Ferrari GM, Stramba-Badiale M, et al. Vagal stimulation and prevention of sudden death in conscious dogs with a healed myocardial infarction. Circ Res. 1991;68:1471–1481
  11. Zamotrinsky AV, Kondratiev B, de Jong JW. Vagal neurostimulation in patients with coronary artery disease. Auton Neurosci. 2001;88:109–116
  12. Schwartz PJ, De Ferrari GM, Sanzo A, et al. Long term vagal stimulation in patients with advanced heart failure (First experience in man). Eur J Heart Fail. 2008;10:884–891
  13. Nadeau R, Cardinal R, Armour JA, et al. Cervical vagosympathetic and mediastinal nerves activation effects on atrial arrhythmia formation. Anadolu Kardiyol Derg. 2007;7(Suppl 1):34–36
  14. Oh S, Zhang Y, Bibevski S, et al. Vagal denervation and atrial fibrillation inducibility: epicardial fat pad ablation does not have long-term effects. Heart Rhythm. 2006;3:701–708
  15. Coumel P. Cardiac arrhythmias and the autonomic nervous system. J Cardiovasc Electrophysiol. 1993;4:338–355
  16. Bettoni M, Zimmermann M. Autonomic tone variations before the onset of paroxysmal atrial fibrillation. Circulation. 2002;105:2753–2759
  17. Fioranelli M, Piccoli M, Mileto GM, et al. Analysis of heart rate variability five minutes before the onset of paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 1999;22:743–749
  18. Coccagna G, Capucci A, Bauleo S, et al. Paroxysmal atrial fibrillation in sleep. Sleep. 1997;20:396–398
  19. Wu TJ, Kim YH, Yashima M, et al. Progressive action potential duration shortening and the conversion from atrial flutter to atrial fibrillation in the isolated canine right atrium. J Am Coll Cardiol. 2001;38:1757–1765
  20. Tan AY, Zhou S, Ogawa M, et al. Neural mechanisms of paroxysmal atrial fibrillation and paroxysmal atrial tachycardia in ambulatory canines. Circulation. 2008;118:916–925
  21. Pappone C, Santinelli V, Manguso F, et al. Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation. 2004;109:327–334
  22. Scanavacca M, Pisani CF, Hachul D, et al. Selective atrial vagal denervation guided by evoked vagal reflex to treat patients with paroxysmal atrial fibrillation. Circulation. 2006;114:876–885
  23. Verma A, Saliba WI, Lakkireddy D, et al. Vagal responses induced by endocardial left atrial autonomic ganglion stimulation before and after pulmonary vein antrum isolation for atrial fibrillation. Heart Rhythm. 2007;4:1177–1182
  24. Katritsis D, Giazitzoglou E, Sougiannis D, et al. Anatomic approach for ganglionic plexi ablation in patients with paroxysmal atrial fibrillation. Am J Cardiol. 2008;102:330–334
  25. Hirose M, Leatmanoratn Z, Laurita KR, et al. Partial vagal denervation increases vulnerability to vagally induced atrial fibrillation. J Cardiovasc Electrophysiol. 2002;13:1272–1279
  26. Shafique S, Dalsing MC. Vagus nerve stimulation therapy for treatment of drug-resistant epilepsy and depression. Perspect Vasc Surg Endovasc Ther. 2006;18:323–327
  27. Srinivasan B, Awasthi A. Transient atrial fibrillation after the implantation of a vagus nerve stimulator. Epilepsia. 2004;45:1645
  28. Braun AP, Phan TD, Sulakhe PV. Muscarinic acetylcholine receptors in the sino-atrial node and right atrium of bovine heart. Eur J Pharmacol. 1990;189:201–215
  29. Beau SL, Hand DE, Schuessler RB, et al. Relative densities of muscarinic cholinergic and beta-adrenergic receptors in the canine sinoatrial node and their relation to sites of pacemaker activity. Circ Res. 1995;77:957–963
  30. Tsutsumi T, Ide T, Yamato M, et al. Modulation of the myocardial redox state by vagal nerve stimulation after experimental myocardial infarction. Cardiovasc Res. 2008;77:713–721
  31. Gupta RC, Imai M, Jiang AJ, et al. Chronic therapy with selective electric vagus nerve stimulation normalizes plasma concentration of tissue necrosis factor-α, interleukin-6 and B-type natriuretic peptide in dogs with heart failure. J Am Coll Cardiol. 2006;47:77A
  32. Tracey KJ. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest. 2007;117:289–296
  33. Zhang Y, Yamada H, Bibevski S, et al. Chronic atrioventricular nodal vagal stimulation: first evidence for long-term ventricular rate control in canine atrial fibrillation model. Circulation. 2005;112:2904–2911
  34. Bianchi S, Rossi P, Scala AD, et al. Endocardial transcatheter stimulation of the AV nodal fat pad: stabilization of rapid ventricular rate response during atrial fibrillation in left ventricular failure. J Cardiovasc Electrophysiol. 2009;20:103–105
  35. Ardell JL, Randall WC. Selective vagal innervation of sinoatrial and atrioventricular nodes in canine heart. Am J Physiol. 1986;251:H764–H773

 This study was supported by the Atrial Fibrillation Innovation Center, the State of Ohio Wright Center of Innovation, and a Biomedical Research and Technology Transfer Partnership Award (Ohio's Third Frontier Project).

PII: S1547-5271(08)01080-1

doi: 10.1016/j.hrthm.2008.10.043

Heart Rhythm
Volume 6, Issue 2 , Pages 244-250 , February 2009

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