What is the clinical evidence from this study?

Study design: Other. Population: Focal atrial fibrillation (n=10). Intervention: Vagal nerve stimulation vs. Baseline (no stimulation) and atropine infusion. Primary outcome: Local effective refractory period (ERP) and atrial fibrillation inducibility at pulmonary vein sites (p=<0.05-0.001).

December 25, 2008Circulation JournalOpen Access

Vagal Effects on the Occurrence of Focal Atrial Fibrillation Originating From the Pulmonary Veins

Q: What are the key findings of this study?

Vagal nerve stimulation significantly shortened the effective refractory period at all pulmonary vein sites and increased the inducibility of atrial fibrillation (P<0.05-0.001).

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Key result

Vagal nerve stimulation significantly shortened the effective refractory period at all pulmonary vein sites and increased the inducibility of atrial fibrillation (P<0.05-0.001).

Why the study?

Does vagal nerve stimulation facilitate the induction of focal atrial fibrillation originating from the pulmonary veins in a canine model?

Population

10 male mongrel dogs weighing 14-25 kg

Comparison

Bilateral cervical vagal nerve stimulation… vs Baseline state and intravenous infusion of…

Design

Preclinical

Authors

PLPeng LiuSouth China University of Technology JGJihong GuoNational Center for Chronic and Noncommunicable Disease Control and Prevention HZHaicheng ZhangChongqing University

Discussion

Member takes

Implication

Supports vagal facilitation of PV AF in canines; hypothesis-generating with no clinical implications yet.

Structured PICO

Does vagal nerve stimulation facilitate the induction of focal atrial fibrillation originating from the pulmonary veins in a canine model?

Population

10 male mongrel dogs weighing 14-25 kg used in an acute experimental model to assess the influence of vagal nerve stimulation on focal atrial fibrillation originating from pulmonary veins.

Intervention

Bilateral cervical vagal nerve stimulation (12.5 Hz, 0.5 ms pulse width) combined with local burst stimulation at the pulmonary veins

Comparator

Baseline state (without vagal nerve stimulation) and intravenous infusion of atropine (muscarinic receptor blockade)

Outcome

Local effective refractory period (ERP), atrial fibrillation (AF) induction, and AF thresholdsurrogate

Main Result

p-value: p=<0.05-0.001

Vagal nerve stimulation shortens the effective refractory period and decreases the threshold for atrial fibrillation induction in pulmonary veins, suggesting parasympathetic involvement in focal AF arrhythmogenesis.

Limitations

Unclear whether atrial premature depolarizations and atrial tachycardias have the same significance for inducing AF.
Without VNS, AF inducibility was very low and frequently could not be obtained at each site within a PV.
Lack of assessment of AF induction in the PVs under provoked variation of local autonomic states.
Individual differences in vagal effects among the dogs.
Cannot exclude the possibility that VNS directly influenced atrial electrophysiological properties rather than just PVs.
Unclear whether APDs and ATs have the same significance for inducing AF
AF induction frequently could not be obtained at each site within a PV
Lack of assessment of AF induction in the PVs under provoked variation of local autonomic states
Unknown whether vagal nerves alone or a combination of vagal and sympathetic nerves are involved
Individual differences in vagal effects
Could not exclude the possibility that VNS directly influenced atrial electrophysiological properties

Cite This Study

Liu et al. (2008) studied Focal atrial fibrillation (n=10). Vagal nerve stimulation vs. Baseline (no stimulation) and atropine infusion was evaluated on Local effective refractory period (ERP) and atrial fibrillation inducibility at pulmonary vein sites (p=<0.05-0.001). Vagal nerve stimulation significantly shortened the effective refractory period at all pulmonary vein sites and increased the inducibility of atrial fibrillation (P<0.05-0.001).

synapsesocial.com/papers/6a7474076a5eb4b8f5090e00 https://doi.org/10.1253/circj.cj-08-0513

Topics

Atrial fibrillation Persistent AF management

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Vagal Effects on the Occurrence of Focal Atrial Fibrillation Originating From the Pulmonary Veins

Discussion

Member takes

Implication

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Vagal Effects on the Occurrence of Focal Atrial Fibrillation Originating From the Pulmonary Veins

Discussion

Member takes

Implication

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider