Effects and parameters of taVNS in individuals with atrial fibrillation: an infographic

Abstract

INTRODUCTION: Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulatory technique used to module autonomic excitability through the electrical stimulus of the vagus nerve. Studies have shown that taVNS can be used as a therapeutic strategy for arterial fibrillation (AF) management. This infographic aims to highlight the evidence about the effect and parameters of taVNS in individuals with AF. METHOD: We conducted a review using the PubMed mesh combination (Transcutaneous Electric Nerve Stimulation)AND(Nerve Stimulation, Vagal))OR(Nerve Stimulation, Vagus))OR(Nerve Stimulations, Vagal))AND(Atrial Fibrillation) that included six taVNS clinical trials with human adults over the age of 18. RESULTS: taVNS can promote an increase in the PQ interval on the electrocardiogram by increasing the parasympathetic tone. Moreover, the taVNS can prevent AF progression through antiarritmogenic effects, such as antiadrenergic mechanisms of neural remodeling, and a decrease of pro-inflammatory cytokines and AF of burden. DISCUSSION: The acute effect of taVNS can increase the P - wave alternans (PWA), which is believed to be related to AF. However, the chronic effect of taVNS for six months promotes a decrease in PWA and AF burden. In addition, the taVNS can alter the heart variability ratio parameters through the increase of the HF/LF relation in individuals with AF, which can be a signal of sympathovagal rebalance. However, the taVNS can improve the autonomic balance through the decrease in HF/LH relation in healthy individuals. CONCLUSION: The taVNS can be a useful therapeutic tool in the management of individuals with AF due to its antiarritmogenic effects.