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Frequency dependent effect of selective biphasic left vagus nerve stimulation on heart rate and arterial pressure

  • TOMISLAV MIRKOVIC1
  • IVAN KNEŽEVIČ2
  • IVAN RADAN 3
  • JANEZ ROZMAN4
  • BORUT GERŠAK2
  • MATEJ PODBREGAR3

1,Clinical Department of Anesthesiology and Intensive Care University Clinical Centre Ljubljana

2Clinical Department of Cardiovascular Surgery , University Clinical Centre Ljubljana

3,Centre for Intensive Care Medicine University Clinical Centre Ljubljana

4,Center for Implantable Technology and Sensors

DOI: 10.22514/SV72.102012.13 Vol.7,Issue 2,October 2012 pp.63-68

Published: 29 October 2012

*Corresponding Author(s): MATEJ PODBREGAR E-mail: matej.podbregar@guest.arnes.si

Abstract

Activation of the parasympathetic pathway leads to negative chronotropic, dromotropic, and inotropic changes of heart function. The ability to selectively stimulate certain superficial compartments of peripheral nerves has been demonstrated previously. The aim of the present study was to find a clinically acceptable selective biphasic vagus nerve stimulation technique, which could allow gradual regulation of heart rate and systemic arterial pressure. In two patients, the left vagus nerve was stimulated with a combination of quasi-trapezoidal cathodic and rectangular anodic current pulses with different stimulation frequencies (10Hz, 20Hz, 30Hz) and increasing current. The heart rate and systemic arterial pressure decreased with increasing current at all different stimulation frequencies (p<0.05). The heart rate and arterial pressure response was more gradual with 10Hz compared to 20Hz/30Hz vagus nerve stimulation (p<0.05). In conclusion, selective vagus nerve stimulation, with a combination of quasi-trapezoidal cathodic and rectangular anodic current pulses at 10Hz, offers gradual heart rate and systolic arterial pressure control. 

Keywords

vagus nerve, electrical stimulation, heart rate, arterial pre-ssure

Cite and Share

TOMISLAV MIRKOVIC,IVAN KNEŽEVIČ,IVAN RADAN ,JANEZ ROZMAN,BORUT GERŠAK,MATEJ PODBREGAR. Frequency dependent effect of selective biphasic left vagus nerve stimulation on heart rate and arterial pressure. Signa Vitae. 2012. 7(2);63-68.

References

1. Carlsten A, Folkow B, Hamberger CA.Cardiovascular effects of direct vagal stimulation in man. Acta Physiol Scand 1957;41:68-76.

2. Henning RJ, Levy MN. Effects of autonomic nerve stimulation, asynchrony, and load on dP/dtmax and on dP/dtmin. Am J Physiol 1991;260: H1290-8.

3. Xenopoluos NP, Applegate RJ. The effect of vagal stimulation on left ventricular systolic and diastolic performance. Am J Physiol 1994;266:H2167-73.

4. Levy MN, Martin PJ. Neural Regulation of the Heart Beat. Annu Rev Physiol 1981;43:443-53.

5. Lewis ME, Al-Khalidi AH, Bonser RS. Vagus nerve stimulation decreases left ventricular contractility in vivo in the human and pig heart. J Physiol 2001; 534:547-52.

6. Matheny RG, Shaar CJ. Vagus nerve stimulation as a method to temporarily slow or arrest the heart. Ann Thorac Surg 1997;63:S28-9.

7. Chase MR. An Experimental Study of the vagus nerve. J Compar Neurol 1996;26:421-8.

8. Sweeney JD, Ksienski DA, Mortimer JT. A nerve cuff technique for selective excitation of peripheral nerve trunk regions. IEEE Trans Biomed Eng 1990;37:706-15.

9. Veraart C, Grill WM, Mortimer JT. Selective control of muscle activation with a multipolar nerve cuff electrode. IEEE Trans Biomed Eng 1993;46:640-53.

10. Goodall EV, de Breij JF, Holsheimer J. Position-selective activation of peripheral nerve fibres with a cuff electrode. IEEE Trans Biomed Eng 1996;43:851-6.

11. Choi AQ, Cavanaugh JK, Durand DM.Selectivity of Multiple-Contact Nerve Cuff Electrodes: A Simulation Analysis. IEEE Trans Biomed Eng 2001;48:165-72.

12. Rozman J, Pe􀀃lin P, Kneževi􀀃 I, Mirkovi􀀃 T, Podbregar M. Heart function influenced by selective mid-cervical left vagus nerve stimulation in a human case study. Hypertens Res 2009;32:1041-3.

13. Hemmerling TM, Olivier JF, Basile F, Le N, Prieto I. Bispectral index as an indicator of cerebral hypoperfusion during off-pump coronary artery bypass grafting. Anesth Analg 2005;100:354-6.

14. Rozman J, Bunc M. Modulation of visceral function by selective stimulation of the left vagus nerve in dogs. Exp Physiol 2004;89:717-25.

15. Sunderland S, Bedbrook GM. The cross-sectional area of peripheral nerve trunks occupied by the fibres representing individual mus-cular and cutaneous branches. Brain 1949;72:613–24.

16. Rossi L, Nappo A. Subdivisions of the extrinsic cardiac nervous system (mediastinal plexi, intercarotid receptors and bulbar center). Pathologica 1994;86:441-2.

17. Zagon A, Ishizuka K, Rocha I, Spyer KM. Slow vagal inhibition in neurones of the ventrolateral medulla oblongata of the rat: a possible mechanism for tonic, vagally evoked sympatho-inhibition. J Hum Hypertens 1997;11:599-600.

18. Spyer KM, Lambert JH, Thomas T. Central nervous system control of cardiovascular function: neural mechanisms and novel modulators. Clin Exp Pharmacol Physio 1997;24:743-7.

19. Hoffman HH, Schnitzlein HN. The numbers of nerve fibres in the vagus nerve of man. Anat Rec 1961;139:429-35.

20. Fang ZP, Mortimer JT. Selective activation of small motor axons by quasitrapezoidal current pulses. IEEE Trans Biomed Eng 1991;38:168-79.

21. Zumstag D, Jenny D, Wieser HG. Vocal cord adduction during vagus nerve stimulation treatment of epilepsy. Neurology 2000;54:1388-9.

22. Hatton KW, McLarney JT, Pittman T, Fahy BG. Vagus nerve stimulation: overview and implications for anesthesiologists. Anast Analg 2006;103:1241-9.

23. Tarver WB, George RE, Maschino SE, Holder LK, Wernicke JF. Clinical experience with a helical bipolar stimulating lead. Pacing Clin Electrophysiol 1992;15:1545-56.

24. Rozman J. Tissue response to chronic selective stimulation of vagus nerve of a dog using multi-electrode spiral cuff. Period Biol 2006;108:2-9.

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