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姿势性直立性心动过速综合征的非侵入性迷走神经刺激

Non-invasive Vagus Nerve Simulation in Postural Orthostatic Tachycardia Syndrome.

作者信息

Chakraborty Praloy, Farhat Kassem, Morris Lynsie, Whyte Seabrook, Yu Xichun, Stavrakis Stavros

机构信息

Heart Rhythm Institute, University of Oklahoma Health and Sciences Center Oklahoma City, OK, US.

出版信息

Arrhythm Electrophysiol Rev. 2023 Dec 13;12:e31. doi: 10.15420/aer.2023.20. eCollection 2023.


DOI:10.15420/aer.2023.20
PMID:38173801
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10762669/
Abstract

Postural orthostatic tachycardia syndrome (POTS) is a chronic debilitating condition of orthostatic intolerance, predominantly affecting young females. Other than postural tachycardia, symptoms of POTS include a spectrum of non-cardiac, systemic and neuropsychiatric features. Despite the availability of widespread pharmacological and non-pharmacological therapeutic options, the management of POTS remains challenging. Exaggerated parasympathetic withdrawal and sympathetic overdrive during postural stress are principal mechanisms of postural tachycardia in POTS. Non-invasive, transcutaneous, vagus nerve stimulation (tVNS) is known to restore sympathovagal balance and is emerging as a novel therapeutic strategy in cardiovascular conditions including arrhythmias and heart failure. Furthermore, tVNS also exerts immunomodulatory and anti-inflammatory effects. This review explores the effects of tVNS on the pathophysiology of POTS and its potential as an alternative non-pharmacological option in this condition.

摘要

体位性直立性心动过速综合征(POTS)是一种慢性使人衰弱的直立不耐受病症,主要影响年轻女性。除了体位性心动过速外,POTS的症状还包括一系列非心脏、全身性和神经精神方面的特征。尽管有广泛的药物和非药物治疗选择,但POTS的管理仍然具有挑战性。体位应激期间过度的副交感神经撤换和交感神经亢进是POTS中体位性心动过速的主要机制。已知非侵入性经皮迷走神经刺激(tVNS)可恢复交感迷走神经平衡,并正在成为包括心律失常和心力衰竭在内的心血管疾病的一种新型治疗策略。此外,tVNS还具有免疫调节和抗炎作用。本综述探讨了tVNS对POTS病理生理学的影响及其作为这种情况下替代非药物选择的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/777fb9e81c68/aer-12-e31-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/266b161484f2/aer-12-e31-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/e4043caed4db/aer-12-e31-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/d5a27fdaf137/aer-12-e31-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/8c3b2db0ab4c/aer-12-e31-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/777fb9e81c68/aer-12-e31-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/266b161484f2/aer-12-e31-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/e4043caed4db/aer-12-e31-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/d5a27fdaf137/aer-12-e31-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/8c3b2db0ab4c/aer-12-e31-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b1e/10762669/777fb9e81c68/aer-12-e31-g005.jpg

相似文献

[1]
Non-invasive Vagus Nerve Simulation in Postural Orthostatic Tachycardia Syndrome.

Arrhythm Electrophysiol Rev. 2023-12-13

[2]
Transdermal auricular vagus stimulation for the treatment of postural tachycardia syndrome.

Auton Neurosci. 2021-12

[3]
Noninvasive Vagus Nerve Stimulation in Postural Tachycardia Syndrome: A Randomized Clinical Trial.

JACC Clin Electrophysiol. 2024-2

[4]
COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review.

Cureus. 2023-3-31

[5]
Transcutaneous vagus nerve stimulation attenuates autoantibody-mediated cardiovagal dysfunction and inflammation in a rabbit model of postural tachycardia syndrome.

J Interv Card Electrophysiol. 2023-3

[6]
Autonomic nervous system dysfunction in adolescents with postural orthostatic tachycardia syndrome and chronic fatigue syndrome is characterized by attenuated vagal baroreflex and potentiated sympathetic vasomotion.

Pediatr Res. 2000-8

[7]
Menstrual cycle phase does not affect sympathetic neural activity in women with postural orthostatic tachycardia syndrome.

J Physiol. 2015-5-1

[8]
Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management.

J Intern Med. 2018-11-23

[9]
Sympathovagal balance analysis in idiopathic postural orthostatic tachycardia syndrome.

Acta Biomed. 2007-8

[10]
Low-level tragus stimulation improves autoantibody-induced hyperadrenergic postural tachycardia syndrome in rabbits.

Heart Rhythm O2. 2022-12-14

引用本文的文献

[1]
Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement.

PM R. 2025-4-22

[2]
Non-invasive Vagus Nerve Stimulation as an Adjunct Treatment for Inappropriate Sinus Tachycardia.

J Innov Card Rhythm Manag. 2025-3-15

本文引用的文献

[1]
Noninvasive Vagus Nerve Stimulation in Postural Tachycardia Syndrome: A Randomized Clinical Trial.

JACC Clin Electrophysiol. 2024-2

[2]
Low-level tragus stimulation improves autoantibody-induced hyperadrenergic postural tachycardia syndrome in rabbits.

Heart Rhythm O2. 2022-12-14

[3]
Plasma proteomic profiling in postural orthostatic tachycardia syndrome (POTS) reveals new disease pathways.

Sci Rep. 2022-11-21

[4]
Sinus Tachycardia: a Multidisciplinary Expert Focused Review.

Circ Arrhythm Electrophysiol. 2022-9

[5]
Abnormal Cardiac Remodeling in Postural Orthostatic Tachycardia Syndrome: Further Insights Into its Cardiac Origin.

JACC Clin Electrophysiol. 2022-8

[6]
Detection of G Protein-Coupled Receptor Autoantibodies in Postural Orthostatic Tachycardia Syndrome Using Standard Methodology.

Circulation. 2022-8-23

[7]
Transcutaneous vagus nerve stimulation attenuates autoantibody-mediated cardiovagal dysfunction and inflammation in a rabbit model of postural tachycardia syndrome.

J Interv Card Electrophysiol. 2023-3

[8]
Neuromodulation of Inflammation to Treat Heart Failure With Preserved Ejection Fraction: A Pilot Randomized Clinical Trial.

J Am Heart Assoc. 2022-2

[9]
Drug-induced orthostatic hypotension: A systematic review and meta-analysis of randomised controlled trials.

PLoS Med. 2021-11-9

[10]
Transdermal auricular vagus stimulation for the treatment of postural tachycardia syndrome.

Auton Neurosci. 2021-12

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