title: Selective AV nodal vagal stimulation improves hemodynamics during acute atrial fibrillation in dogs.
abstract: Although the atrioventricular node (AVN) plays a vital role in blocking many of the atrial impulses from reaching the ventricles during atrial fibrillation (AF), a rapid irregular ventricular rate nevertheless persists. The goals of the present study were to explore the feasibility of novel epicardial selective vagal nerve stimulation for slowing of the ventricular rate during AF and to characterize the hemodynamic benefits in vivo. Electrophysiological-echocardiographic experiments were performed on 11 anesthetized open-chest dogs. Hemodynamic measurements were performed during three distinct periods: 1) sinus rate, 2) AF, and 3) AF with vagal nerve stimulation. AF was associated with significant deterioration of all measured parameters (P < 0.025). The vagal nerve stimulation produced slowing of the ventricular rate, significant reversal of the pressure and contractile indexes (P < 0.025), and a sharp reduction in one-half of the abortive ventricular contractions. The present study provides comprehensive evidence that slowing of the ventricular rate during AF by selective ganglionic stimulation of the vagal nerves that innervate the AVN successfully improved the hemodynamic responses.
authors.affiliation: Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Wallick
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: T
authors.initials: T
authors.lastname: Tabata
authors.forename: S
authors.initials: S
authors.lastname: Zhuang
authors.forename: K A
authors.initials: KA
authors.lastname: Mowrey
authors.forename: J
authors.initials: J
authors.lastname: Watanabe
authors.forename: N L
authors.initials: NL
authors.lastname: Greenberg
authors.forename: R A
authors.initials: RA
authors.lastname: Grimm
authors.forename: T N
authors.initials: TN
authors.lastname: Mazgalev
mesh_terms: D000208:Acute Disease; D000273:Adipose Tissue / Q000503:physiopathology; D000818:Animals; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001283:Atrioventricular Node / Q000503:physiopathology*; D004285:Dogs; D004452:Echocardiography; D004558:Electric Stimulation; D006339:Heart Rate; D006439:Hemodynamics; D010496:Pericardium / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology*