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Chronic atrioventricular nodal vagal stimulation: first evidence for long-term ventricular rate control in canine atrial fibrillation model

Cited 37 time in Web of Science Cited 38 time in Scopus
Authors
Zhang, Youhua; Yamada, Hirotsugu; Bibevski, Steve; Zhuang, Shaowei; Mowrey, Kent A; Wallick, Don W; Oh, Seil; Mazgalev, Todor N
Issue Date
2005-11-02
Publisher
American Heart Association
Citation
Circulation. 2005 Nov 8;112(19):2904-11. Epub 2005 Oct 31.
Keywords
AnimalsAtrial Fibrillation/*therapyAtrioventricular Node/*innervationDisease Models, AnimalDogsElectric Stimulation Therapy/*methodsTelemetryVagus Nerve/*physiology*Ventricular Function
Abstract
BACKGROUND: We have previously demonstrated that selective atrioventricular nodal (AVN) vagal stimulation (AVN-VS) can be used to control ventricular rate during atrial fibrillation (AF) in acute experiments. However, it is not known whether this approach could provide a long-term treatment in conscious animals. Thus, this study reports the first observations on the long-term efficacy and safety of this novel approach to control ventricular rate during AF in chronically instrumented dogs. METHODS AND RESULTS: In 18 dogs, custom-made bipolar patch electrodes were sutured to the epicardial AVN fat pad for delivery of selective AVN-VS by a subcutaneously implanted nerve stimulator (pulse width 100 micros or 1 ms, frequency 20 or 160 Hz, amplitude 6 to 10 V). Fast-rate right atrial pacing (600 bpm) was used to induce and maintain AF. ECG, blood pressure, and body temperature were monitored telemetrically. One week after the induction of AF, AVN-VS was delivered and maintained for at least 5 weeks. It was found that AVN-VS had a consistent effect on ventricular rate slowing (on average 45+/-13 bpm) over the entire period of observation. Echocardiography showed improvement of cardiac indices with ventricular rate slowing. AVN-VS was well tolerated by the animals, causing no signs of distress or discomfort. CONCLUSIONS: Beneficial long-term ventricular rate slowing during AF can be achieved by implantation of a nerve stimulator attached to the epicardial AVN fat pad. This novel concept is an attractive alternative to other methods of rate control and may be applicable in a selected group of patients.
ISSN
1524-4539 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16260638

http://hdl.handle.net/10371/29524
DOI
https://doi.org/10.1161/CIRCULATIONAHA.105.568832
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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