Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction

Marmar Vaseghi, Siamak Salavatian, Pradeep S. Rajendran, Daigo Yagishita, William Woodward, David Hamon, Kentaro Yamakawa, Tadanobu Irie, Beth Habecker, Kalyanam Shivkumar

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Myocardial infarction causes sympathetic activation and parasympathetic dysfunction, which increase risk of sudden death due to ventricular arrhythmias. Mechanisms underlying parasympathetic dysfunction are unclear. The aim of this study was to delineate consequences of myocardial infarction on parasympathetic myocardial neurotransmitter levels and the function of parasympathetic cardiac ganglia neurons, and to assess electrophysiological effects of vagal nerve stimulation on ventricular arrhythmias in a chronic porcine infarct model. While norepinephrine levels decreased, cardiac acetylcholine levels remained preserved in border zones and viable myocardium of infarcted hearts. In vivo neuronal recordings demonstrated abnormalities in firing frequency of parasympathetic neurons of infarcted animals. Neurons that were activated by parasympathetic stimulation had low basal firing frequency, while neurons that were suppressed by left vagal nerve stimulation had abnormally high basal activity. Myocardial infarction increased sympathetic inputs to parasympathetic convergent neurons. However, the underlying parasympathetic cardiac neuronal network remained intact. Augmenting parasympathetic drive with vagal nerve stimulation reduced ventricular arrhythmia inducibility by decreasing ventricular excitability and heterogeneity of repolarization of infarct border zones, an area with known proarrhythmic potential. Preserved acetylcholine levels and intact parasympathetic neuronal pathways can explain the electrical stabilization of infarct border zones with vagal nerve stimulation, providing insight into its antiarrhythmic benefit.

Original languageEnglish (US)
JournalJCI insight
Volume2
Issue number16
DOIs
StatePublished - Aug 17 2017

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Vagus Nerve Stimulation
Myocardial Infarction
Neurons
Cardiac Arrhythmias
Acetylcholine
Parasympathetic Ganglia
Sudden Death
Neurotransmitter Agents
Myocardium
Norepinephrine
Swine

Keywords

  • Cardiology

Cite this

Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction. / Vaseghi, Marmar; Salavatian, Siamak; Rajendran, Pradeep S.; Yagishita, Daigo; Woodward, William; Hamon, David; Yamakawa, Kentaro; Irie, Tadanobu; Habecker, Beth; Shivkumar, Kalyanam.

In: JCI insight, Vol. 2, No. 16, 17.08.2017.

Research output: Contribution to journalArticle

Vaseghi, M, Salavatian, S, Rajendran, PS, Yagishita, D, Woodward, W, Hamon, D, Yamakawa, K, Irie, T, Habecker, B & Shivkumar, K 2017, 'Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction', JCI insight, vol. 2, no. 16. https://doi.org/10.1172/jci.insight.86715
Vaseghi, Marmar ; Salavatian, Siamak ; Rajendran, Pradeep S. ; Yagishita, Daigo ; Woodward, William ; Hamon, David ; Yamakawa, Kentaro ; Irie, Tadanobu ; Habecker, Beth ; Shivkumar, Kalyanam. / Parasympathetic dysfunction and antiarrhythmic effect of vagal nerve stimulation following myocardial infarction. In: JCI insight. 2017 ; Vol. 2, No. 16.
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