Low‐Level Tragus Stimulation Modulates Atrial Alternans and Fibrillation Burden in Patients With Paroxysmal Atrial Fibrillation
| Autor: | Stavros Stavrakis, Jagmeet P. Singh, Demosthenes G. Katritsis, Kimberly A. Parks, Antonis A. Armoundas, Kanchan Kulkarni |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Vagal stimulation Time Factors vagal stimulation Vagus Nerve Stimulation Paroxysmal atrial fibrillation Action Potentials Stimulation spectral method Autonomic Nervous System Proof of Concept Study Electrocardiography Heart Rate Internal medicine Atrial Fibrillation medicine Humans In patient Arrhythmia and Electrophysiology Heart Atria Paroxysmal AF Original Research Aged Fibrillation business.industry Atrial fibrillation Middle Aged medicine.disease Electrophysiology Treatment Outcome P‐wave alternans Cardiology Transcutaneous Electric Nerve Stimulation Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background Low‐level tragus stimulation (LLTS) has been shown to significantly reduce atrial fibrillation (AF) burden in patients with paroxysmal AF. P‐wave alternans (PWA) is believed to be generated by the same substrate responsible for AF. Hence, PWA may serve as a marker in guiding LLTS therapy. We investigated the utility of PWA in guiding LLTS therapy in patients with AF. Methods and Results Twenty‐eight patients with AF were randomized to either active LLTS or sham (earlobe stimulation). LLTS was delivered through a transcutaneous electrical nerve stimulation device (pulse width 200 μs, frequency 20 Hz, amplitude 10–50 mA), for 1 hour daily over a 6‐month period. AF burden over 2‐week periods was assessed by noninvasive continuous ECG monitoring at baseline, 3 months, and 6 months. A 5‐minute control ECG for PWA analysis was recorded during all 3 follow‐up visits. Following the control ECG, an additional 5‐minute ECG was recorded during active LLTS in all patients. At baseline, acute LLTS led to a significant rise in PWA burden. However, active patients receiving chronic LLTS demonstrated a significant reduction in both PWA and AF burden after 6 months ( P Conclusions Chronic, intermittent LLTS resulted in lower PWA and AF burden than did sham control stimulation. Our results support the use of PWA as a potential marker for guiding LLTS treatment of paroxysmal AF. |
| Databáze: | OpenAIRE |
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