scholarly journals Device-Based Approaches to Modulate the Autonomic Nervous System and Cardiac Electrophysiology

2014 ◽  
Vol 3 (1) ◽  
pp. 30-35 ◽  
Author(s):  
William J Hucker ◽  
Jagmeet P Singh ◽  
Kimberly Parks ◽  
Antonis A Armoundas

Alterations in resting autonomic tone can be pathogenic in many cardiovascular disease states, such as heart failure and hypertension. Indeed, autonomic modulation by way of beta-blockade is a standard treatment of these conditions. There is a significant interest in developing non-pharmacological methods of autonomic modulation as well. For instance, clinical trials of vagal stimulation and spinal cord stimulation in the treatment of heart failure are currently underway, and renal denervation has been studied recently in the treatment of resistant hypertension. Notably, autonomic stimulation is also a potent modulator of cardiac electrophysiology. Manipulating the autonomic nervous system in studies designed to treat heart failure and hypertension have revealed that autonomic modulation may have a role in the treatment of common atrial and ventricular arrhythmias as well. Experimental data on vagal nerve and spinal cord stimulation suggest that each technique may reduce ventricular arrhythmias. Similarly, renal denervation may play a role in the treatment of atrial fibrillation, as well as in controlling refractory ventricular arrhythmias. In this review, we present the current experimental and clinical data on the effect of these therapeutic modalities on cardiac electrophysiology and their potential role in arrhythmia management.

2016 ◽  
Vol 17 (5) ◽  
pp. 498
Author(s):  
Alyssa Conte Da Silva ◽  
Juliana Falcão Padilha ◽  
Jefferson Luiz Brum Marques ◽  
Cláudia Mirian De Godoy Marques

Introdução: Existem poucos estudos que evidenciam a manipulação vertebral relacionada à modulação autonômica cardíaca. Objetivo: Revisar a literatura sobre os efeitos da manipulação vertebral sobre a modulação autonômica cardíaca. Métodos: Foi realizada uma busca bibliográfica nas bases de dados da saúde Medline, Pubmed e Cinahl, no período correspondido entre setembro e novembro de 2014. Foram utilizados os descritores em inglês Spinal Manipulation, Cardiac Autonomic Modulation, Autonomic Nervous System, Heart Rate Variability, além de associações entre eles. Resultados: Foram encontrados 190 artigos, sendo excluídos 39 por serem repetidos, restando 151. Destes, 124 não se encaixaram nos critérios de inclusão e após leitura crítica e análise dos materiais foram selecionados 7 artigos. Grande parte dos estudos revelou que a manipulação da coluna, independente do segmento, demonstra alterações autonômicas, tanto em nível simpático quanto parassimpático. Conclusão: Existem diferentes metodologias para avaliação da modulação autonômica cardíaca, sendo a Variabilidade da Frequência cardíaca através do eletrocardiograma a mais utilizada. A manipulação vertebral exerceu influência, na maioria dos artigos, sobre a modulação autonômica cardíaca.Palavras-chave: manipulação da coluna, sistema nervoso autônomo, variabilidade da frequência cardíaca. 


2015 ◽  
Vol 28 (3) ◽  
pp. 627-636 ◽  
Author(s):  
Gustavo Henrique de Oliveira Mondoni ◽  
Luiz Carlos Marques Vanderlei ◽  
Bruno Saraiva ◽  
Franciele Marques Vanderlei

AbstractIntroduction It is known that physical exercise is beneficial and precipitates adjustments to the autonomic nervous system. However, the effect of exercise on cardiac autonomic modulation in children, despite its importance, is poorly investigated.Objective To bring together current information about the effects of exercise on heart rate variability in healthy and obese children.Methods The literature update was performed through a search for articles in the following databases; PubMed, PEDro, SciELO and Lilacs, using the descriptors “exercise” and “child” in conjunction with the descriptors “autonomic nervous system”, “sympathetic nervous system”, “parasympathetic nervous system” and also with no descriptor, but the key word of this study, “heart rate variability”, from January 2005 to December 2012.Results After removal of items that did not fit the subject of the study, a total of 9 articles were selected, 5 with healthy and 4 with obese children.Conclusion The findings suggest that exercise can act in the normalization of existing alterations in the autonomic nervous system of obese children, as well as serve as a preventative factor in healthy children, enabling healthy development of the autonomic nervous system until the child reaches adulthood.


2018 ◽  
Vol 1 (21;1) ◽  
pp. E409-E418
Author(s):  
Leandro Nogueira

Background: Patients with chronic musculoskeletal pain have a higher chance of presenting impairment in cardiovascular autonomic modulation, which may have implications for cardiovascular events. The autonomic nervous system plays an important role in pain modulation. However, it is unclear whether patients with inefficient descending nociceptive inhibition have poorer cardiovascular autonomic modulation. Objective: To compare the cardiovascular autonomic modulation of patients with musculoskeletal pain who had normal versus impaired functioning of descending nociceptive inhibitory system (DNIS). Study Design: A cross-sectional study. Setting: Physiotherapy outpatient service. Methods: Fifty-six patients with musculoskeletal pain were included. Conditioned pain modulation was assessed by the difference of algometric values held in the dorsal forearm and tibialis anterior muscle, before and after a thermal pain stimulus was employed via the cold pressure test (CPT). Patients with inefficient DNIS in both sites were classified as impaired responders (n = 14). The others were classified as normal responders (n = 42). Cardiac autonomic modulation was monitored at rest by heart rate variability (HRV). The blood pressure response to the CPT was used as a proxy of sympathetic responsiveness. Results: Most of the patients were women (60%) and had chronic pain (75%). The groups had similar demographic characteristics. Patients with impaired DNIS showed lower HRV [RMSSD (P = 0.020), SDRR (P = 0.009), HF (ms2 ) (P = 0.027), LF (ms2 ) (P = 0.004), and total power (P = 0.002)]. The blood pressure response to CPT was similar between groups (systolic pressure, P = 0.813; diastolic pressure, P = 0.709). Limitation: Physical activity level, emotional changes, and visceral pathologies can alter the autonomic nervous system and may represent potential confounders. The low number of patients may have biased the results. Conclusion: Patients with impaired DNIS presented lower resting HRV, indicating an altered vagal control of the heart. In contrast, the blood pressure response to a sympathoexcitatory stimulus was preserved. The study was approved by the Research Ethics Committee of Augusto Motta University Centre (CAAE number: 46245215.9.0000.5235), and all patients signed the Informed Consent Form. Key words: Musculoskeletal pain, autonomic nervous system, heart rate, chronic pain, diffuse noxious inhibitory control, blood pressure, sympathetic nervous system, parasympathetic nervous system


2015 ◽  
Vol 3 (3) ◽  
pp. 197-205 ◽  
Author(s):  
Jill M. Wecht ◽  
Michael F. La Fountaine ◽  
John P. Handrakis ◽  
Christopher R. West ◽  
Aaron Phillips ◽  
...  

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