Drug-Free Correction of the Tone of the Autonomic Nervous System in the Management of Cardiac Arrhythmia in Coronary Artery Disease

Sergey V. Popov, PhD, ScD, Sergey A. Afanasiev, PhD, ScD, Igor O. Kurlov, PhD, Anna V. Pisklova, PhD
2013 International Journal of Biomedicine  
The aim of our study was to examine the possibility of ventricular extrasystole (VES) management in CAD (coronary artery disease) patients by attenuating the sympathetic activity with a course of electrical stimulation of the vagus nerve. Methods: A decrease in sympathetic tone was achieved via vagus nerve electrical stimulation (VNES). VNES was performed in 48 male CAD patients, mean age 53.5±4.1 years. Antiarrhythmic drug therapy was canceled prior to VNES therapy. The effect of VNES on heart
more » ... ct of VNES on heart rate variability (HRV) and VES were carefully studied. All the patients received a 24-hour ECG monitoring. HRV was calculated for high frequency (HF) and low frequency (LF) bands and the LF/HF index was determined. Results: Immediately following VNES therapy, 30 patients (group 1) reported alleviation of angina signs and the LF/HF index was significantly decreased (p=0.001). Eighteen patients (group 2) showed no change either in health or the LF/HF index. According to ECG and echocardiography, the VES number did not significantly change immediately after VNES therapy. One month after the VNES course, group 1 reported further improvement in health; the LF/HF index approached normal values. In group 2, the LF/HF significantly decreased (p=0.043). However, in the entire study sample, the VES number significantly decreased overall (p=0.025). Conclusion: VNES attenuated the cardiac effects of hypersympathicotonia decreased the ischemic impact on the myocardium, alleviated the cardiac angina signs, and beneficially influenced the VES number in CAD patients.
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