Key result
Left cardiac vagal transection reduces contralateral right vagal firing rate by ~22% from baseline.
Why the study?
The impact of acute unilateral injury on spontaneous electrical activity in both vagus nerves at the heart level is poorly understood.
Does acute unilateral cardiac vagal nerve transection alter spontaneous electrical activity in the contralateral vagus nerve in minipigs?
Does acute unilateral cardiac vagal nerve transection alter spontaneous electrical activity in the contralateral vagus nerve in minipigs?
Effect estimate: -21.8% in intact right VN
Left cardiac vagotomy induces a rapid left-lateralized reduction in vagal spiking activity, suggesting right vagus monitoring could predict left vagal injury during cardiac procedures.
Hypothesis-generating for contralateral vagal monitoring in cardiac procedures; leaves open translation from minipig data to humans.
BACKGROUND: The impact of acute unilateral injury on spontaneous electrical activity in both vagus nerves at the heart level is poorly understood. We investigated the immediate neuroelectrical response after right or left cardiac vagal nerve transection (VNTx) by recording spiking activity of each heart vagus nerve (VN). METHODS: Fourteen male Göttingen minipigs underwent sternotomy. Multi-electrode cuffs were implanted below the cut level to record vagal electroneurographic signals during electrocardiographic and hemodynamic monitoring, before and immediately after cardiac VNTx (left: L-cut, n = 6; right: R-cut, n = 8). RESULTS: Left cardiac VNTx significantly reduced multi-unit electrical activity (MUA) firing rate in the vagal stump (-30.7% vs pre-cut) and intact right VN (-21.8% vs pre-cut) at the heart level, without affecting heart rate, heart rate variability, or hemodynamics. In contrast, right cardiac VNTx did not acutely alter MUA in either VN but slightly increased (p < 0.022) the root mean square of successive RR interval differences (rMSSD), an index of parasympathetic outflow, without affecting hemodynamics. CONCLUSIONS: Our study reveals an early left-lateralized pattern in vagal spiking activity following unilateral cardiac vagotomy. These findings enhance understanding of the neuroelectrical response to vagal injury and provide insights into preserving vagal outflow after unilateral cardiac vagotomy. Importantly, monitoring spiking activity of the cardiac right VN may predict onset of left vagal pathway injury, which is detrimental to cardiac patients and can occur as a complication of catheter ablation for atrial fibrillation.
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Vallone et al. (2023) studied Healthy (vagal nerve evaluation) (n=14). Left or right cardiac vagal nerve transection vs. Pre-transection baseline was evaluated on Multi-unit electrical activity (MUA) firing rate (-21.8% in intact right VN). Left cardiac vagal nerve transection significantly reduced multi-unit electrical activity firing rate in the intact right vagus nerve by 21.8% compared to pre-cut baseline.
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