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Noninvasive Vagus Nerve Stimulation in Postural Tachycardia Syndrome: A Randomized Clinical Trial.
Stavrakis, Stavros; Chakraborty, Praloy; Farhat, Kassem; Whyte, Seabrook; Morris, Lynsie; Abideen Asad, Zain Ul; Karfonta, Brittany; Anjum, Juvaria; Matlock, H Greg; Cai, Xue; Yu, Xichun.
Afiliación
  • Stavrakis S; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Electronic address: stavros-stavrakis@ouhsc.edu.
  • Chakraborty P; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Farhat K; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Whyte S; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Morris L; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Abideen Asad ZU; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Karfonta B; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Anjum J; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Matlock HG; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Cai X; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
  • Yu X; University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
JACC Clin Electrophysiol ; 10(2): 346-355, 2024 Feb.
Article en En | MEDLINE | ID: mdl-37999672
BACKGROUND: Low-level transcutaneous stimulation of the auricular branch of the vagus nerve at the tragus is antiarrhythmic and anti-inflammatory in animals and humans. Preliminary studies show that transcutaneous vagus nerve stimulation (tVNS) is beneficial in animal models of postural tachycardia syndrome (POTS). OBJECTIVES: In this study the authors conducted a sham-controlled, double-blind, randomized clinical trial to examine the effect of tVNS on POTS over a 2-month period relative to sham stimulation. METHODS: tVNS (20 Hz, 1 mA below discomfort threshold) was delivered using an ear clip attached to either the tragus (active; n = 12) or the ear lobe (sham; n = 14) for 1 hour daily over a 2-month period. Postural tachycardia was assessed during the baseline and 2-month visit. Heart rate variability based on 5-minute electrocardiogram, serum cytokines, and antiautonomic autoantibodies were measured at the respective time points. RESULTS: Mean age was 34 ± 11 years (100% female; 81% Caucasian). Adherence to daily stimulation was 83% in the active arm and 86% in the sham arm (P > 0.05). Postural tachycardia was significantly less in the active arm compared with the sham arm at 2 months (mean postural increase in heart rate 17.6 ± 9.9 beats/min vs 31.7 ± 14.4 beats/min; P = 0.01). Antiadrenergic autoantibodies and inflammatory cytokines were lower in the active arm compared with the sham arm at 2 months (P < 0.05). Heart rate variability was better in the active arm. No device-related side effects were observed. CONCLUSIONS: Our results support the emerging paradigm of noninvasive neuromodulation to treat POTS. Mechanistically, this effect appears to be related to reduction of antiautonomic autoantibodies and inflammatory cytokines, and improvement in autonomic tone. Further studies are warranted. (Autoimmune Basis for Postural Tachycardia Syndrome; NCT05043051).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Taquicardia Postural Ortostática / Estimulación del Nervio Vago Límite: Adult / Animals / Female / Humans / Male / Middle aged Idioma: En Revista: JACC Clin Electrophysiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Taquicardia Postural Ortostática / Estimulación del Nervio Vago Límite: Adult / Animals / Female / Humans / Male / Middle aged Idioma: En Revista: JACC Clin Electrophysiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos