JUNIPER PUBLISHERS-Journal of Cardiology & Cardiovascular Therapy

The Effect of Low-Level Electrical Stimulation of the Aortic Root Ventricular Ganglionated Plexi on the Treatment of Heart Failure

Authored by Qiang-Sun Zheng*

Congenital heart failure (HF) is one of the most popular heart disease, which is often accompanied by arrhythmia especially atrial fibrillation (AF). Both HF and AF share the similar underlying pathogenesis such as structural, neurohormonal, and electrical atrial or ventricular remodeling. Unfortunately, traditional pharmacological therapy may not be as useful for the treatment of HF in patients with AF as it is in patients in normal sinus rhythm. Because imbalanced tone of autonomic nervous system (ANS) plays the key role in the initiation of AF in patient with HF, modulation of ANS became a hotly debated point in the current research and practice.

Strong vagal stimulation had long been used to induce AF and high level nerve stimulation is considered to facilitate both AF and HF. Recently, Li et al. gave a novel idea that low-level electrical stimulation (LL-ES) of vagal nerve VNS could suppress AF by inhibiting the intrinsic cardiac autonomic nervous system (ANS) and prevent episodic AF arising from pulmonary vein or non-pulmonary vein. Following Li's study, increasing evidences suggested that LL-ES of vagal nerve, with voltage levels 10-50% below threshold showed an antiarrhythmic effect. Furthermore, Stavrakis et al. demonstrated that transcutaneous LL-ES suppresses AF and decreases inflammatory cytokines in patients with paroxysmal AF. These results indicated LL-ES of autonomic nerve could bring both anti- arrhythmia and anti-inflammation effect.

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