title: Vagus nerve stimulation-induced bradyarrhythmias in rats.
abstract: The autonomic consequences of seizures can be severe. Death can follow from autonomic overactivity that causes a parasympathetically mediated bradyarrhythmia. We studied the cardiovascular consequences of unilateral and bilateral stimulation of the distal segments of transected vagus nerve in rats anesthetized with urethane. The range of stimulation rates tested is comparable to the firing rates observed in vagus nerve during seizures. There was a consistent inverse relation between stimulus rate and heart rate with nodal block appearing at 5-10 Hz and minimum HR levels (cardiac standstill) occurring at 50 Hz. Cardiac standstill could last many seconds. Blood pressure during VNS was maintained during lower frequency VNS, but collapsed at frequencies > or =20 Hz to dramatically impair ventricular filling. Recovery of heart rate and blood pressure after VNS was rapid. In the presence of sympathetic co-activation (pharmacological or hypercapnia and/or hypoxia), mean arterial pressure was better maintained and there was much better ventricular filling, but cardiac performance was worse (e.g. ejection fraction derived from echocardiography). The combination of sympathetic and parasympathetic overactivity was sometimes associated with prolonged (> or =20 s) apneic periods during VNS. We conclude that an abrupt increase in parasympathetic activity on the order of 5 times the background of parasympathetic tone can produce transient bradyarrhythmias, and increases on the order of 20 times can produce cardiac standstill, sometimes accompanied by apnea. Our findings suggest that parasympathetically mediated bradyarrhythmia must be accompanied by airway obstruction to sustain parasympathetic overactivity and produce hypoxia to ultimately cause death.
authors: Department of the Autonomic Nervous System, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Harumi
authors: H
authors: Hotta
authors: Jason
authors: J
authors: Lazar
authors: Rena
authors: R
authors: Orman
authors: Kiyomi
authors: K
authors: Koizumi
authors: Kanako
authors: K
authors: Shiba
authors: Haroon
authors: H
authors: Kamran
authors: Mark
authors: M
authors: Stewart
mesh_terms: D000818:Animals; D001049:Apnea / Q000209:etiology / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D001919:Bradycardia / Q000209:etiology / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004195:Disease Models, Animal; D004827:Epilepsy / Q000150:complications / Q000503:physiopathology*; D006321:Heart / Q000294:innervation / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D008297:Male; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D051381:Rats; D017208:Rats, Wistar; D013318:Stroke Volume / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology; D020421:Vagus Nerve Diseases / Q000209:etiology / Q000503:physiopathology*; D055536:Vagus Nerve Stimulation / Q000009:adverse effects