Chakraborty Praloy, Farhat Kassem, Morris Lynsie, Whyte Seabrook, Yu Xichun, Stavrakis Stavros
Heart Rhythm Institute, University of Oklahoma Health and Sciences Center Oklahoma City, OK, US.
Arrhythm Electrophysiol Rev. 2023 Dec 13;12:e31. doi: 10.15420/aer.2023.20. eCollection 2023.
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.
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。
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