Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Heart Rhythm. 2017 Dec;14(12):1771-1778. doi: 10.1016/j.hrthm.2017.07.035. Epub 2017 Aug 1.
We recently reported that skin sympathetic nerve activity (SKNA) can be used to estimate sympathetic tone in humans. In animal models, vagal nerve stimulation (VNS) can damage the stellate ganglion, reduce stellate ganglion nerve activity, and suppress cardiac arrhythmia. Whether VNS can suppress sympathetic tone in humans remains unclear.
The purpose of this study was to test the hypothesis that VNS suppresses SKNA in patients with drug-resistant epilepsy.
ECG patch electrodes were used to continuously record SKNA in 26 patients with drug-resistant epilepsy who were admitted for video electroencephalographic monitoring. Among them, 6 (2 men, age 40 ± 11 years) were previously treated with VNS and 20 (7 men, age 37 ± 8 years) were not. The signals from ECG leads I and II were filtered to detect SKNA.
VNS had an on-time of 30 seconds and off-time of 158 ± 72 seconds, with output of 1.92 ± 0.42 mA at 24.17 ± 2.01 Hz. Average SKNA during VNS off-time was 1.06 μV (95% confidence interval [CI] 0.93-1.18) in lead I and 1.13 μV (95% CI 0.99-1.27) in lead II, which was significantly lower than 1.38 μV (95% CI 1.01-1.75; P = .036) and 1.38 μV (95% CI 0.98-1.78; P = .035) in the control group, respectively. Heart rate was 65 bpm (95% CI 59-71) in the VNS group, which was significantly lower than 77 bpm (95% CI 71-83) in the control group.
Patients with VNS had significantly lower SKNA than those without VNS.
我们最近报道称，皮肤交感神经活动（SKNA）可用于评估人类的交感神经张力。在动物模型中，迷走神经刺激（VNS）可损伤星状神经节，减少星状神经节神经活动，并抑制心律失常。VNS 是否可抑制人类的交感神经张力尚不清楚。
本研究旨在检验假设，即 VNS 可抑制耐药性癫痫患者的 SKNA。
使用心电图贴片电极连续记录 26 例接受视频脑电图监测的耐药性癫痫患者的 SKNA。其中，6 例（2 名男性，年龄 40 ± 11 岁）曾接受 VNS 治疗，20 例（7 名男性，年龄 37 ± 8 岁）未接受 VNS 治疗。从心电图导联 I 和 II 中筛选信号以检测 SKNA。
VNS 的开启时间为 30 秒，关闭时间为 158 ± 72 秒，输出为 24.17 ± 2.01 Hz 时的 1.92 ± 0.42 mA。VNS 关闭期间，导联 I 的平均 SKNA 为 1.06 μV（95%置信区间 [CI] 0.93-1.18），导联 II 为 1.13 μV（95% CI 0.99-1.27），显著低于对照组的 1.38 μV（95% CI 1.01-1.75；P =.036）和 1.38 μV（95% CI 0.98-1.78；P =.035）。VNS 组的心率为 65 bpm（95% CI 59-71），显著低于对照组的 77 bpm（95% CI 71-83）。
接受 VNS 治疗的患者的 SKNA 显著低于未接受 VNS 治疗的患者。
