Low-Level Vagus Nerve Stimulation Suppresses Post-Operative Atrial Fibrillation and Inflammation
| Autor: | Christian D. Fleming, Yanqing Hu, Sunny S. Po, Marvin D. Peyton, Mubasher Abbas, Arthur McUnu, Mary Beth Humphrey, Benjamin J. Scherlag, Paul Garabelli, Stavros Stavrakis, Adrian Filiberti, Omer Iftikhar, Purvi Parwani |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty business.industry medicine.medical_treatment Hazard ratio Atrial fibrillation 030204 cardiovascular system & hematology medicine.disease Intensive care unit law.invention Vagus nerve Cardiac surgery 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Randomized controlled trial law Anesthesia Heart rate Medicine business Vagus nerve stimulation |
| Zdroj: | JACC: Clinical Electrophysiology. 3:929-938 |
| ISSN: | 2405-500X |
| DOI: | 10.1016/j.jacep.2017.02.019 |
| Popis: | Objectives 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. Background POAF often complicates cardiac surgery. Methods 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. Results 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 patients developed any complications as a result of wire placement. At 72 h, serum tumor necrosis factor-α and interleukin-6 levels were significantly lower in the LLVNS group than in the control group. Conclusions These data suggest that LLVNS suppresses POAF and attenuates inflammation in patients undergoing cardiac surgery. Further studies are warranted. |
| Databáze: | OpenAIRE |
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