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SONG ZL, QIN M, LIU X. Cardioneuroablation for the treatment of symptomatic bradycardia mediated by the cardiac autonomic nervous. J Geriatr Cardiol 2023; 20:615-617. [PMID: 37840635 PMCID: PMC10568549 DOI: 10.26599/1671-5411.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
- Zi-Liang SONG
- Department of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mu QIN
- Department of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xu LIU
- Department of Cardiology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Soltani D, Azizi B, Sima S, Tavakoli K, Hosseini Mohammadi NS, Vahabie AH, Akbarzadeh-Sherbaf K, Vasheghani-Farahani A. A systematic review of the effects of transcutaneous auricular vagus nerve stimulation on baroreflex sensitivity and heart rate variability in healthy subjects. Clin Auton Res 2023; 33:165-189. [PMID: 37119426 DOI: 10.1007/s10286-023-00938-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/27/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE This systematic review aimed to evaluate the effect of transcutaneous auricular vagus nerve stimulation on heart rate variability and baroreflex sensitivity in healthy populations. METHOD PubMed, Scopus, the Cochrane Library, Embase, and Web of Science were systematically searched for controlled trials that examined the effects of transcutaneous auricular vagus nerve stimulation on heart rate variability parameters and baroreflex sensitivity in apparently healthy individuals. Two independent researchers screened the search results, extracted the data, and evaluated the quality of the included studies. RESULTS From 2458 screened studies, 21 were included. Compared with baseline measures or the comparison group, significant changes in the standard deviation of NN intervals, the root mean square of successive RR intervals, the proportion of consecutive RR intervals that differ by more than 50 ms, high-frequency power, low-frequency to high-frequency ratio, and low-frequency power were found in 86%, 75%, 69%, 47%, 36%, and 25% of the studies evaluating the effects of transcutaneous auricular vagus nerve stimulation on these indices, respectively. Baroreflex sensitivity was evaluated in six studies, of which a significant change was detected in only one. Some studies have shown that the worse the basic autonomic function, the better the response to transcutaneous auricular vagus nerve stimulation. CONCLUSION The results were mixed, which may be mainly attributable to the heterogeneity of the study designs and stimulation delivery dosages. Thus, future studies with comparable designs are required to determine the optimal stimulation parameters and clarify the significance of autonomic indices as a reliable marker of neuromodulation responsiveness.
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Affiliation(s)
- Danesh Soltani
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bayan Azizi
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Sima
- Department of Psychology, University of Tehran, Tehran, Iran
| | - Kiarash Tavakoli
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Sadat Hosseini Mohammadi
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Abdol-Hossein Vahabie
- Control and Intelligent Processing Center of Excellence (CIPCE), Cognitive Systems Laboratory, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Kaveh Akbarzadeh-Sherbaf
- Department of Computer Engineering and Information Technology, Imam Reza International University, Mashhad, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Zhong S, Cai Q, Zhong L, Wang Y, Liang F, Deng Z, Li S, Zha D, Qiu W, Wu J. Low-Intensity Focused Ultrasound Ameliorates Ischemic Heart Failure Related to the Cholinergic Anti-Inflammatory Pathway. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:463-475. [PMID: 36444908 DOI: 10.1002/jum.16140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/30/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES This study aims to determine the effect of low-intensity focused ultrasound (LIFU) in ischemic heart failure (IHF) and explore the potential neuroimmune mechanism. METHODS Sprague-Dawley rats were subjected to ultrasound (US) with specific parameters, and electrocardiograms were recorded to analyze the effect of LIFU and/or vagal denervation on heart rate. Thereafter, myocardial infarction (MI) was induced by left anterior artery ligation, and LIFU was performed three times a day for 25 days after MI. Echocardiography, Masson staining, and ELISA were used to evaluate the effect of LIFU on the structure and function of the heart. Finally, ELISA, flow cytometry, qRT-PCR, and Western blot analysis were performed to determine the effect of LIFU on the inflammation and the expression of the cholinergic anti-inflammatory pathway (CAP)-related mediators. RESULTS LIFU reduced heart rate in rats (control vs LIFU, P < .01), and vagotomy (VT) eliminated this effect of LIFU on heart rate (VT vs LIFU + VT, P > .01). LIFU-ameliorated IHF in terms of cardiac structure and function (MI vs MI + LIFU, P < .01), but VT abrogated the beneficial effect of LIFU (MI + VT vs MI + LIFU + VT, P > .01). After the treatment of LIFU, decreased levels of inflammatory cytokines, increased proportion of anti-inflammatory macrophages, and increased expression of CAP-related mediators (MI vs MI + LIFU, P < .01). CONCLUSIONS LIFU ameliorates IHF whereas the CAP plays a promising role. LIFU has the potential to be a novel nonpharmacological and noninvasive therapy for the treatment of coronary artery disease and other cardiovascular diseases.
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Affiliation(s)
- Shenrong Zhong
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Cardiology, Meizhou People's Hospital, Meizhou, China
| | - Qianyun Cai
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Longhe Zhong
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuegang Wang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fengchu Liang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhe Deng
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shasha Li
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Daogang Zha
- Department of General Practice, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weibao Qiu
- Shenzhen Key Laboratory of Ultrasound Imaging and Therapy, Chinese Academy of Sciences, Shenzhen, China
| | - Juefei Wu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Guangzhou, China
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Chen M, Wang S, Li X, Yu L, Yang H, Liu Q, Tang J, Zhou S. Non-invasive Autonomic Neuromodulation Is Opening New Landscapes for Cardiovascular Diseases. Front Physiol 2021; 11:550578. [PMID: 33384606 PMCID: PMC7769808 DOI: 10.3389/fphys.2020.550578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/27/2020] [Indexed: 01/09/2023] Open
Abstract
Autonomic imbalance plays a crucial role in the genesis and maintenance of cardiac disorders. Approaches to maintain sympatho-vagal balance in heart diseases have gained great interest in recent years. Emerging therapies However, certain types of emerging therapies including direct electrical stimulation and nerve denervation require invasive implantation of a generator and a bipolar electrode subcutaneously or result in autonomic nervous system (ANS) damage, inevitably increasing the risk of complications. More recently, non-invasive neuromodulation approaches have received great interest in ANS modulation. Non-invasive approaches have opened new fields in the treatment of cardiovascular diseases. Herein, we will review the protective roles of non-invasive neuromodulation techniques in heart diseases, including transcutaneous auricular vagus nerve stimulation, electromagnetic field stimulation, ultrasound stimulation, autonomic modulation in optogenetics, and light-emitting diode and transcutaneous cervical vagus nerve stimulation (gammaCore).
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Affiliation(s)
- Mingxian Chen
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Songyun Wang
- Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Xuping Li
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lilei Yu
- Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Hui Yang
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiming Liu
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jianjun Tang
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shenghua Zhou
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
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Aksu T, Erdem Guler T. Cardioneuroablation in the Management of Vasovagal Syncope, Sinus Node Dysfunction and Functional Atrioventricular Block: Patient Selection Based on Supporting Evidence. J Atr Fibrillation 2020; 13:2396. [PMID: 33024497 PMCID: PMC7533142 DOI: 10.4022/jafib.2396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/11/2020] [Accepted: 03/16/2020] [Indexed: 11/10/2022]
Abstract
The problem with the regulation of the autonomic nervous system or paroxysmal reflex vagal activation episodes may have an important role in the pathophysiology of vasovagal syncope (VVS), sinus bradycardia or periods of sinus arrest, and variable-degree atrioventricular block (AVB). Because existence of structural heart disease tends to shift the vagosympathetic balance towards a sympathetic predominance, vagally-mediated bradyarrhythmias (VMB) usually occurs in young individuals with structurally normal hearts. However, similar reflex problems may be observed in the elderly people and even those with structural heart disease. Modification of the efferent arm of autonomic nervous system by ablation of main ganglionated plexi (GPs) is called as cardioneuroablation (CNA) and seems as a promising treatment option for appropriately selected patients with VMB. This review outlines the process of patient selection for CNA on the basis of supporting evidence.
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Affiliation(s)
- Tolga Aksu
- University of Health Sciences, Kocaeli Derince Training and Research Hospital, Department of Cardiology, Kocaeli, Turkey
| | - Tumer Erdem Guler
- University of Health Sciences, Kocaeli Derince Training and Research Hospital, Department of Cardiology, Kocaeli, Turkey
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Rivarola E, Scanavacca M. Cardiac Autonomic Modulation - The Search for an Ultimate Technique. Arq Bras Cardiol 2017; 109:384-386. [PMID: 29267623 PMCID: PMC5729771 DOI: 10.5935/abc.20170166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Esteban Rivarola
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
| | - Mauricio Scanavacca
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
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