Transvenous vagal nerve stimulation (VNS) in acute myocardial infarction (AMI) reduces the infarct size and improves long term cardiac function

VNS is known to have an anti-infarct effect. However, the technical difficulty associated with VNS precludes its application under clinical settings of AMI. We developed a novel technique where we stimulate the vagal nerves transvenously, and evaluated how the VNS affects the infarction size and cardiac function in the long term. We ligated the left anterior descending coronary artery for 3 hours, then reperfused. For transvenous VNS, we performed the field electrical stimulation at the superior vena cava. One month after the ischemia-reperfusion, we compared the infarct size and cardiac function with/without VNS. Transvenous VNS significantly decreased the infarction size by more than 80% (1.1±1.2 vs. 7.8±1.2cm², p<0.05), doubled left ventricular systolic elastance (13.2±0.6 vs. 6.5±1.7 mmHg/ml, p<0.05), and decreased NT-pro BNP (843±256 vs. 3667±1637 pmol/ml, p<0.05). In conclusion, transvenous VNS in AMI markedly reduces the infarct size and improves cardiac function in the long term.