TY - GEN
T1 - The challenge of magnetic vagal nerve stimulation for myocardial infarction -preliminary clinical trial
AU - Nishikawa, Takuya
AU - Saku, Keita
AU - Todaka, Koji
AU - Kuwabara, Yukimitsu
AU - Arai, Shinobu
AU - Kishi, Takuya
AU - Ide, Tomomi
AU - Tsutsui, Hiroyuki
AU - Sunagawa, Kenji
N1 - Funding Information:
VI. ACKNOWLEDGMENT The authors thank Mr. Yoshinori Murayama and staff of the Department of Cardiovascular Medicine, Kyushu University and Center for Clinical and Translational Research for technical support. In addition, this work was supported by Grant-in-Aid from Translational Research Network Program (B7), Research and development of supportive device technology for medicine using ICT, AMED-SENTAN; Development of Advanced Measurement and Analysis Systems, and Grant-in-Aid for Young Scientists (B) (15K19383) from the Japan Society for the Promotion of Science.
PY - 2017/9/13
Y1 - 2017/9/13
N2 - Numerous studies have shown in animal models that vagal nerve stimulation (VNS) strikingly reduces infarct size of acute myocardial infarction (AMI) and prevents heart failure. However, the lack of techniques to noninvasively stimulate the vagal nerve hinders VNS from clinical applications. Transcranial magnetic stimulation is noninvasive and capable of stimulating central neurons in patients. In this study, we examined whether the magnetic stimulation could noninvasively activate the cervical vagal nerve in healthy human. Sixteen healthy males and 4 females were enrolled in this study. We used Magstim Rapid2 with a 70-mm double coil in the right neck. We randomly assigned the subjects to 5 Hz or 20 Hz stimulation. We defined the maximum intensity of stimulation (MAX) which is the intensity just below the threshold of adverse effects. We defined HALF as a half of MAX. Protocols comprised 2 sets of MAX and 2 sets of HALF. Each stimulation continued for 3 minutes. We monitored heart rate (HR) and assessed the bradycardic response as an index of successful VNS. Nineteen subjects completed all protocols. They had no problematic adverse events during and/or after magnetic VNS. The magnetic VNS induced transient bradycardic responses in some subjects, whereas failed to induce sustained bradycardia in pooled data in any settings. Arterial pressure did not change either. Successful magnetic stimulation requires technical improvements including narrowing the magnetic focus and optimization of stimulation site. These improvements may enable us to apply magnetic VNS in the management of AMI.
AB - Numerous studies have shown in animal models that vagal nerve stimulation (VNS) strikingly reduces infarct size of acute myocardial infarction (AMI) and prevents heart failure. However, the lack of techniques to noninvasively stimulate the vagal nerve hinders VNS from clinical applications. Transcranial magnetic stimulation is noninvasive and capable of stimulating central neurons in patients. In this study, we examined whether the magnetic stimulation could noninvasively activate the cervical vagal nerve in healthy human. Sixteen healthy males and 4 females were enrolled in this study. We used Magstim Rapid2 with a 70-mm double coil in the right neck. We randomly assigned the subjects to 5 Hz or 20 Hz stimulation. We defined the maximum intensity of stimulation (MAX) which is the intensity just below the threshold of adverse effects. We defined HALF as a half of MAX. Protocols comprised 2 sets of MAX and 2 sets of HALF. Each stimulation continued for 3 minutes. We monitored heart rate (HR) and assessed the bradycardic response as an index of successful VNS. Nineteen subjects completed all protocols. They had no problematic adverse events during and/or after magnetic VNS. The magnetic VNS induced transient bradycardic responses in some subjects, whereas failed to induce sustained bradycardia in pooled data in any settings. Arterial pressure did not change either. Successful magnetic stimulation requires technical improvements including narrowing the magnetic focus and optimization of stimulation site. These improvements may enable us to apply magnetic VNS in the management of AMI.
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U2 - 10.1109/EMBC.2017.8037812
DO - 10.1109/EMBC.2017.8037812
M3 - Conference contribution
C2 - 29060853
AN - SCOPUS:85032201158
T3 - Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
SP - 4321
EP - 4324
BT - 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society
PB - Institute of Electrical and Electronics Engineers Inc.
T2 - 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2017
Y2 - 11 July 2017 through 15 July 2017
ER -
