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.
Highlights
The use of nerve stimulation for treating and controlling a variety of medical, psychiatric, and neurological disorders has seen significant growth over the last several decades
(7) The ability to selectively stimulate certain superficial compartments of peripheral nerves has been demonstrated by several authors. [8,9,10,11] We have previously reported that selective vagal nerve stimulation (VNS) in humans is possible
Changes of heart rate and systemic systolic arterial pressure during VNS are presented in figures 1
Summary
The use of nerve stimulation for treating and controlling a variety of medical, psychiatric, and neurological disorders has seen significant growth over the last several decades. [1,2,3] Currently VNS has numerous potential clinical applications from heart failure to endocrine regulation. [5,6] The vagus nerve is composed of different fiber types. [7] The ability to selectively stimulate certain superficial compartments of peripheral nerves has been demonstrated by several authors. [8,9,10,11] We have previously reported that selective VNS in humans is possible. [12] detailed human data on selective biphasic VNS and its effects on heart rate and systemic arterial pressure are not available. The aim of the present study was to find a clinically acceptable selective biphasic VNS at different stimulation frequencies, which could allow gradual regulation of heart rate and systemic arterial pressure
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