Chronic vagus nerve stimulation is associated with multi-year improvement in intrinsic heart rate recovery and left ventricular ejection fraction in ANTHEM-HF
| Autor: | Bruce D. Nearing, Richard L. Verrier, Badri Amurthur, Bruce H. KenKnight, Imad Libbus, Gerrard M. Carlson |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Baroreceptor Neurology Vagus Nerve Stimulation medicine.medical_treatment Heart failure 030204 cardiovascular system & hematology Autonomic Nervous System Heart rate turbulence Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine Diabetes mellitus Medicine Humans Autonomic regulation therapy Ejection fraction Endocrine and Autonomic Systems business.industry Stroke Volume Vagus Nerve medicine.disease Heart rate recovery Treatment Outcome Baroreflex sensitivity Ambulatory Cardiology Neurology (clinical) business 030217 neurology & neurosurgery Vagus nerve stimulation Research Article |
| Zdroj: | Clinical Autonomic Research |
| ISSN: | 1619-1560 0959-9851 |
| Popis: | Purpose Disturbed autonomic function is implicated in high mortality rates in heart failure patients. High-intensity vagus nerve stimulation therapy was shown to improve intrinsic heart rate recovery and left ventricular ejection fraction over a period of 1 year. Whether these beneficial effects are sustained across multiple years and are related to improved baroreceptor response was unknown. Methods All patients (n = 21) enrolled in the ANTHEM-HF clinical trial (NCT01823887, registered 4/3/2013) with 24 h ambulatory electrocardiograms at all time points and 54 normal subjects (PhysioNet database) were included. Intrinsic heart rate recovery, based on ~ 2000 spontaneous daily activity-induced heart rate acceleration/deceleration events per patient, was analyzed at screening and after 12, 24, and 36 months of chronic vagus nerve stimulation therapy (10 or 5 Hz, 250 μs pulse width, 18% duty cycle, maximum tolerable current amplitude). Results In response to chronic high-intensity vagus nerve stimulation (≥ 2.0 mA), intrinsic heart rate recovery (all time points, p p ≤ 0.02), and left ventricular ejection fraction (all, p ≤ 0.04) were improved over screening at 12, 24, and 36 months. Intrinsic heart rate recovery and heart rate turbulence slope were inversely correlated at both screening (r = 0.67, p r = 0.78, p Conclusion This non-randomized study provides evidence of an association between improvement in intrinsic heart rate recovery and left ventricular ejection fraction during high-intensity vagus nerve stimulation for a period of ≥ 3 years. Correlated favorable effects on heart rate turbulence slope implicate enhanced baroreceptor function in response to chronic, continuously cyclic vagus nerve stimulation as a physiologic mechanism. |
| Databáze: | OpenAIRE |
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