Low-Level Vagus Nerve Stimulation Suppresses Post-Operative Atrial Fibrillation and Inflammation: A Randomized Study

JACC. Clinical Electrophysiology
Stavros StavrakisSunny S Po

Abstract

This study sought to examine the efficacy of low-level vagus nerve stimulation (LLVNS) in suppressing post-operative atrial fibrillation (POAF) and inflammatory cytokines in patients undergoing cardiac surgery. POAF often complicates cardiac surgery. Patients undergoing cardiac surgery were randomized to active or sham LLVNS. In all patients, a bipolar wire was sutured to the vagus nerve pre-ganglionic fibers alongside the lateral aspect of the superior vena cava. High-frequency (20 Hz) stimulation, 50% below the threshold for slowing the heart rate, was delivered for 72 h in the LLVNS group. The development of POAF was monitored continuously during the entire hospital stay by use of telemetry. Blood was collected on arrival in the intensive care unit and at 24 and 72 h for measurement of inflammatory cytokines. Patients were followed up within 1 month after cardiac surgery. A total of 54 patients were randomized to either active LLVNS (n = 26) or sham control (n = 28). The baseline characteristics of the patients were balanced in the 2 groups. POAF occurred in 3 patients (12%) in the LLVNS group and 10 patients (36%) in the control group (hazard ratio: 0.28; 95% confidence interval: 0.10 to 0.85; p = 0.027). None of the patien...Continue Reading

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Citations

Jul 16, 2019·Expert Review of Medical Devices·Yuhong WangHong Jiang
Oct 11, 2019·Circulation. Arrhythmia and Electrophysiology·Jordana Kron, Alex Y Tan
Oct 11, 2019·Circulation. Arrhythmia and Electrophysiology·Martin AndreasMichael Wolzt
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Jan 14, 2022·Journal of the American Heart Association·Stavros StavrakisMary Beth Humphrey

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