Intermittent low-level vagosympathetic nerve trunk stimulation inhibits ganglionated plexi activity to prevent atrial fibrillation

Int J Clin Exp Med. 2015 Apr 15;8(4):5094-102. eCollection 2015.

Abstract

Background: The cardiac autonomic nervous system (CANS) plays a role in the occurrence and persistence of atrial fibrillation (AF). Low-level vagosympathetic nerve stimulation (LL-VNS) has been shown to inhibit the occurrence of AF.

Objective: The novel objective of this study was to compare the effects of intermittent low- level vagosympathetic nerve stimulation (I-VNS) and continuous low-level vagosympathetic nerve stimulation (C-VNS).

Methods: 19 beagles were randomly divided into 3 groups: Group A, rapid left atrial appendage pacing for 6 hours; Group B, rapid atrial pacing (RAP) for 6 hours and C-VNS (20 Hz, interval 0.1 ms, square wave) with 50% threshold voltage strength; Group C, RAP for 6 hours and I-VNS (continuously recurring cycles of 30-second ON, 30-second OFF). The atrial monophasic action potential (MAP) and the effective refractory periods (ERP) of the atrium and the pulmonary veins were measured at baseline, 1 hour, 3 hours and 6 hours after the experiment began. After the experiment, tyrosine hydroxylase (TH) and choline acetyl transferase (CHAT) expression levels in the anterior right ganglionated plexi (ARGP) from each group were measured.

Results: Inter-group comparisons of MAP and ERP demonstrated that Group A was significantly different from Groups B and C (P < 0.05), while the difference between Groups B and C was not significant (P > 0.05). The MAP and ERP in Group A gradually decreased, reaching a minimum at 6 hours, but no significant changes were observed in Groups B and C. When compared to Group A, both Groups B and C had reduced TH and CHAT expression.

Conclusions: During the occurrence and development of AF, I-VNS could protect the cardiovascular system, possibly replacing C-VNS. Additionally, both I-VNS and C-VNS inhibited ganglionated plexus (GP) activity during the AF prevention.

Keywords: Atrial fibrillation; ganglionated plexus; vagosympathetic nerve.