Microvolt T-Wave Alternans Is Modulated by Acute Low-Level Tragus Stimulation in Patients With Ischemic Cardiomyopathy and Heart Failure

• DOI: 10.3389/fphys.2021.707724
• Publication Date: 2021-07-23T12:11:16Z
• Authors: Kanchan Kulkarni; Stavros Stavrakis; Khaled Elkholey; Jagmeet P. Singh; Kimberly A. Parks; Antonis A. Armoundas
• Keywords: Ischemic Cardiomyopathy; T wave alternans; Vagus Nerve Stimulation

Aims: Microvolt T-wave alternans (TWA), an oscillation in morphology of the electrocardiogram (ECG), has been associated with increased susceptibility to ventricular tachy-arrhythmias, while vagus nerve stimulation shown promising anti-arrhythmic effects vivo and ex animal studies. We aimed examine effect non-invasive, acute low-level tragus (LLTS) on TWA patients ischemic cardiomyopathy heart failure. Methods: 26 (left ejection fraction <35%) chronic stable failure, previously implanted automatic implantable cardioverter defibrillator (ICD) device atrial lead (dual chamber ICD or cardiac resynchronization therapy defibrillator), were enrolled study. Each patient sequentially received, (1) Sham LLTS (electrode tragus, but no delivered) for 5 min; (2) Active at two different frequencies (5 20 Hz, 15 min each); (3) LLTS, during concomitant pacing 100 bpm each). was delivered through a transcutaneous electrical (pulse width 200 μs, frequency 5/20 amplitude 1 mA lower than discomfort threshold). burden assessed using continuous ECG monitoring sham active sinus rhythm, as well pacing. Results: Right led significantly heightened compared without LLTS. Acute both rhythm significant rise precordial leads ( p < 0.05). Conclusion: results heart-rate dependent increase burden.