Abstract
A study was made to evaluate the prospects of improving the cardiac function by electrical stimulation of the auricular branch of the vagus nerve in patients with severe chronic heart failure (CHF). Sympathetic hyperactivity and the cardiac function were evaluated by 24-hour ECG monitoring, echocardiography, and a 6-min walk test. At the time of enrollment into the study, patients had a heart rate (HR) of more than 60 bpm, a left ventricular (LV) ejection fraction (EF) of less than 40%, and CHF NYHA functional class (FC) III or IV even with well tolerated medications. Control-group patients (n = 7) did not show significant changes in the functional state of the heart after sham treatment. In the test group (n = 44), a significant increase in LV EF and a decrease in end-systolic volume were induced by electrical pulse stimulation of the auricular branch. A decrease in HR was documented in 34 patients; CHF FC decreased by one or two grades in 40 patients. The changes were assumed to reflect new balance achieved in the autonomic regulation of the heart to contribute to sustaining competence of the myocardium. Electrical pulse stimulation of the auricular branch of the vagus nerve was concluded to provide a safe and efficacious addition to drug therapy in patients with severe CHF.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Konradi, A.O., Autonomic nervous system in arterial hypertension and heart failure: current understanding of its pathophysiologic role and innovative treatment approaches, Ross. Kardiol. Zh., 2013, vol. 4, no. 102, p. 52.
Konradi, A.O., Interrelation between sympathetic and renin-angiotensin systems: role in arterial hypertension, Arterial’naya Gipertenz., 2012, vol. 18, no. 6, p. 577.
Gavras, A., Manolis, A.Dzh., and Gavras, Kh., Paradigm of sympathetic suppression in chronic heart failure, Mezhdunar. Med. Zh., 2000, no. 3, p. 213.
Mitoff, P.R., Gam, D., Ivanov, J., et al., Cardiac-specific sympathetic activation in men and women with and without heart failure, Heart, 2011, vol. 97, no. 5, p. 382.
Akutsu, Y., Kaneko, K., Kodama, Y., et al., The significance of cardias sympathetic nervous system abnormality in the long-term prognosis of patients with a history of ventricular tachyarrhythmia, J. Nucl. Med., 2009, vol. 50, p. 61.
Olshansky, B., Sabbah, H.N., Hauptman, P.J., and Colucci, W.S., Parasympathetic nervous system and heart failure: pathophysiology and potential implications for therapy, Circulation, 2008, vol. 118, p. 863.
Singh, R.B., Demeester, F., and Wilczynska, A., The tsim tsoum approaches for prevention of cardiovascular disease, Cardiol. Res. Pract., 2010, vol. 2010, article 824938. http://dxdoiorg/10.4061/2010/824938.
Singh, R.B., Gupta, S., Dherange, P., et al., Metabolic syndrome: a brain disease, Can. J. Physiol. Pharmacol., 2012, vol. 90, no. 9, p. 1171.
Chen, S.W. and Chao, S.C., Compressed sensing for integral pulse frequency modulation (IPFM)-based heart rate variability spectral estimation, Proc. Conf. IEEE Eng. Med. Biol. Soc., 2012, p. 5626.
Afanasev, S.A., Ugdyzhekova, D.S., and Karpov, R.S., Contribution of a-adrenoreceptors to the contractility of the human myocardium in chronic coronary heart disease, Hum. Physiol., 2005, vol. 31, no. 1, p. 114.
Galagudza, M.M., Shlyakhto, E.V., Vlasov, T.D., et al., Kardioprotektsiya: fundamental’nye i klinicheskie aspekty (Cardioprotection: Fundamental and Clinical Aspects), St. Petersburg: NP-Print, 2013.
Khlopov, N.A., Sharafislamov, F.Sh., Rybakova, L.S., et al., Topografo-anatomicheskie osnovy akupunktury (Topographo-Anatomical Basics of Acupuncture), Alma- Ata: Nauka, 1988.
Pesikov, Ya.S. and Rybalko, S.Ya., Atlas klinicheskoi aurikuloterapii (Atlas of Clinical Auriculotherapy), Moscow: Meditsina, 1990.
Zamotrinsky, A., Afanasiev, S., Karpov, R.S., and Cherniavsky, A., Effects of electrostimulation of the vagus afferent endings in patients with coronary artery disease, Coron. Artery Dis., 1997, vol. 8, nos. 8–9, p. 551.
Popov, S.V., Afanasiev, S.A., Kurlov, I.O., and Pisklova, A.V., Drug-free correction of the tone of the autonomic nervous system in the management of cardiac arrhythmia in coronary artery disease, Int. J. Biomed., 2013, vol. 3, no. 2, p. 74.
Pavlyukova, E.N., Kuz’michkina, M.A., Afanas’ev, S.A., and Karpov, R.S., Auricular vagal stimulation in the treatment of patients with left ventricular dysfunction, Klin. Med., 2013, no. 7, p. 27.
Mareev, V.Yu., Ageev, F.T., Arutyunov, G.P., et al., National recommendations PRAS, CSC, and REMOT for the diagnosis and treatment of CHF (fourth revision), Serdechnaya Nedostatochnost’, 2013, vol. 14, no. 7, p. 379.
Kalyuzhin, V.V., Kalyuzhin, O.V., Teplyakov, A.T., and Karaulov, A., Khronicheskaya serdechnaya nedostatochnost’: voprosy etiologii, epidemiologii, patogeneza (gemodinamicheskie, neirogumoral’nye, immunnye, geneticheskie aspekty), diagnostiki i lecheniya: ucheb. posobie (Chronic Heart Failure: Problems of Etyology, Epidemiology, Pathogenesis (Hemodynamical, Neurohumoral, Immune, and Genetic Aspects), Moscow: MIA, 2006.
Ryabykina, G.V. and Sobolev, A.V., Kholterovskoe i bifunktsional’noe monitorirovanie EKG i arterial’nogo davleniya (Holter and Bifunctional Monitoring of Arterial Pressure), Moscow: Medpraktika-M, 2010.
Wang, W., Xie, J.X., Liu, L., et al., Agreement comparison between home and clinic blood pressure measurements in 200 Chinese participants, Blood Press. Monit., 2011, vol. 16, no. 6, p. 277.
Carnethon, M.R., Yan, L., Greenland, P., et al., The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors, Int. J. Cardiol., 2010, vol. 141, p. 122.
Routledge, F.S., Campbell, T.S., McFetridge-Durdle, J.A., and Bacon, S.L., Improvements in heart rate variability with exercise therapy, Can. J. Cardiol., 2010, vol. 26, no. 6, p. 303.
Glants, S., Mediko-biologicheskaya statistika (Biomedical Statistics), Moscow: Praktika, 1999.
Floras, J.S., Sympathetic nervous system activation in human heart failure, J. Am. Coll. Cardiol., 2009, vol. 54, no. 5, p. 375.
De Ferrari, G.M., Crijns, H.J., Borggrefe, M., et al., CardioFit Multicenter Trial Investigators. Chronic vagus nerve stimulation: a new and promising therapeutic approach for chronic heart failure, Eur. Heart J., 2011, vol. 32, no. 7, p. 847.
Klein, H.U. and Ferrari, G.M., Vagus nerve stimulation: a new approach to reduce heart failure, Cardiol. J., 2010, vol. 17, no. 6, p. 638.
Sabbah, H.N., Electrical vagus nerve stimulation for the treatment of chronic heart failure, Cleve Clin. J. Med., 2011, vol. 78, no. 1, p. 24.
Nakayama, Y., Miyano, H., Shishido, T., et al., Heart rate—independent vagal effect on end-systolic elastance of the canine left ventricle under various levels of sympathetic tone, Circulation, 2001, vol. 104, p. 2277.
Author information
Authors and Affiliations
Corresponding author
Additional information
Original Russian Text © S.A. Afanasiev, E.N. Pavlyukova, M.A. Kuzmichkina, Y.D. Anfinogenova, R.S. Karpov, 2016, published in Fiziologiya Cheloveka, 2016, Vol. 42, No. 4, pp. 77–82.
Rights and permissions
About this article
Cite this article
Afanasiev, S.A., Pavlyukova, E.N., Kuzmichkina, M.A. et al. Effect of stimulating the auricular branch of the vagus nerve on the heart rate in patients with severe chronic heart failure. Hum Physiol 42, 416–420 (2016). https://doi.org/10.1134/S0362119716030026
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1134/S0362119716030026