scholarly journals Multi-year improvement in autonomic tone, baroreceptor sensitivity, and cardiac electrical stability using vagus nerve stimulation in patients with HFrEF in the ANTHEM-HF study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B.D Nearing ◽  
I Libbus ◽  
I.S Anand ◽  
L.A Dicarlo ◽  
B.H Kenknight ◽  
...  
Keyword(s):  
Heart Rate ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Funding Source ◽  
Autonomic Tone ◽  
Electrical Stability ◽  
Baroreceptor Sensitivity ◽  
Rr Interval

Abstract Background HFrEF patients experience long-term deterioration of autonomic function and cardiac electrical stability linked to increased sudden cardiac death risk. ANTHEM-HF (NCT01823887) reported improved baroreceptor sensitivity (heart rate turbulence, HRT), heart rate variability (rMSSD), and reduced cardiac electrical instability (T-wave alternans, TWA) after 12 months of chronic vagus nerve stimulation (VNS). It is unknown whether these benefits persist long-term. Methods HRT, rMSSD, TWA, and VT occurrence were evaluated during chronic VNS in all patients with symptomatic HFrEF with available 36-month follow-up data (n=25). ECGs were analyzed before Autonomic Regulation Therapy system implantation (LivaNova USA) and after chronic cervical VNS. Results Improvement in HRT slope persisted at 24 months (8.1±1.2 ms/RR interval, p=0.02) and 36 months (7.9±0.9 ms/RR interval, p=0.03) of VNS compared to baseline. RMSSD increase continued at 24 months (34.6±2.7 ms2, p<0.02) and 36 months (36.4±2.0 ms2, p=0.002). Peak TWA levels remained reduced at 24 months (47.8±1.3 μV, p<0.0001) and 36 months (46.1±1.6 μV, p<0.0001). No sudden death, VF, or sustained VT occurred, and patients with nonsustained VT decreased from 11 (44%) at baseline to 1 (5%) at 24 months (p<0.003) and 2 (11%) at 36 months (p<0.02). Conclusion In patients with HFrEF, chronic VNS appears to confer persistent 3-year improvements in autonomic tone, baroreceptor sensitivity, and cardiac electrical stability. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): LivaNova PLC

Long Term Effects of Low Frequency (10 Hz) Vagus Nerve Stimulation on EEG and Heart Rate Variability in Crohn's Disease: A Case Report

2014 ◽  
Vol 7 (6) ◽  
pp. 914-916 ◽  
Author(s):  
Didier Clarençon ◽  
Sonia Pellissier ◽  
Valérie Sinniger ◽  
Astrid Kibleur ◽  
Dominique Hoffman ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Crohn’S Disease ◽  
Case Report ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Low Frequency ◽  
Long Term Effects

scholarly journals An implant for long-term cervical vagus nerve stimulation in mice

2020 ◽  
Author(s):  
Ibrahim T. Mughrabi ◽  
Jordan Hickman ◽  
Naveen Jayaprakash ◽  
Eleni S. Papadoyannis ◽  
Adam Abbas ◽  
...  
Keyword(s):  
Heart Rate ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Therapeutic Potential ◽  
Therapeutic Implications ◽  
Wide Range ◽  
Heart Rate Threshold

AbstractVagus nerve stimulation (VNS) is a neuromodulation therapy with the potential to treat a wide range of chronic conditions in which inflammation is implicated, including type 2 diabetes, obesity, atherosclerosis and heart failure. Many of these diseases have well-established mouse models but due to the significant surgical and engineering challenges that accompany a reliable interface for long-term VNS in mice, the therapeutic implications of this bioelectronic approach remain unexplored. Here, we describe a long-term VNS implant in mice, developed at 3 research laboratories and validated for between-lab reproducibility. Implant functionality was evaluated over 3-8 weeks in 81 anesthetized or conscious mice by determining the stimulus intensity required to elicit a change in heart rate (heart rate threshold, HRT). HRT was also used as a method to standardize stimulation dosing across animals. Overall, 60-90% of implants produced stimulus-evoked physiological responses for at least 4 weeks, with HRT values stabilizing after the second week of implantation. Furthermore, stimulation delivered through 6-week-old implants decreased TNF levels in a subset of mice with acute inflammation caused by endotoxemia. Histological examination of 4- to 6-week-old implants revealed fibrotic encapsulation and no gross fiber loss. This implantation and dosing approach provide a tool to systematically investigate the therapeutic potential of long-term VNS in chronic diseases modeled in the mouse, the most widely used vertebrate species in biomedical research.

scholarly journals Development and characterization of a chronic implant mouse model for vagus nerve stimulation

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Ibrahim T Mughrabi ◽  
Jordan Hickman ◽  
Naveen Jayaprakash ◽  
Dane Thompson ◽  
Umair Ahmed ◽  
...  
Keyword(s):  
Heart Rate ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Axonal Pathology ◽  
Device Implantation ◽  
Preclinical And Clinical Studies ◽  
Stimulation Of

Vagus nerve stimulation (VNS) suppresses inflammation and autoimmune diseases in preclinical and clinical studies. The underlying molecular, neurological, and anatomical mechanisms have been well characterized using acute electrophysiological stimulation of the vagus. However, there are several unanswered mechanistic questions about the effects of chronic VNS, which require solving numerous technical challenges for a long-term interface with the vagus in mice. Here, we describe a scalable model for long-term VNS in mice developed and validated in 4 research laboratories. We observed significant heart rate responses for at least 4 weeks in 60-90% of animals. Device implantation did not impair vagus-mediated reflexes. VNS using this implant significantly suppressed TNF levels in endotoxemia. Histological examination of implanted nerves revealed fibrotic encapsulation without axonal pathology. This model may be useful to study the physiology of the vagus and provides a tool to systematically investigate long-term VNS as therapy for chronic diseases modeled in mice.

Vagus nerve stimulation for drug-resistant epilepsy

2019 ◽  
Vol 20 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Laura Pérez-Carbonell ◽  
Howard Faulkner ◽  
Sean Higgins ◽  
Michalis Koutroumanidis ◽  
Guy Leschziner
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Therapeutic Option ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Randomised Controlled

Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%–40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.

scholarly journals Vagus nerve stimulation improves severely impaired heart rate variability in a patient with Lennox-Gastaut-Syndrome

Seizure ◽  
2008 ◽  
Vol 17 (5) ◽  
pp. 469-472 ◽  
Author(s):  
Stephan A. Koenig ◽  
Elke Longin ◽  
Nellie Bell ◽  
Julia Reinhard ◽  
Thorsten Gerstner
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation

Bursted auricular vagus nerve stimulation alters heart rate variability in healthy subjects

2021 ◽  
Author(s):  
Jozsef Constantin Széles ◽  
Stefan Kampusch ◽  
Florian Thürk ◽  
Christian Clodi ◽  
Norbert Thomas ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Healthy Subjects
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