Cervical vagal nerve stimulation activates the stellate ganglion in ambulatory dogs

Kyoung Suk Rhee, Chia Hsiang Hsueh, Jessica A. Hellyer, Hyung Wook Park, Young Soo Lee, Jason Garlie, Patrick Onkka, Anisiia T. Doytchinova, John B. Garner, Jheel Pate, Lan Chen, Michael C. Fishbein, Thomas Everett, Shien-Fong Lin, Peng-Sheng Chen

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and Objectives: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. Materials and Methods: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. Results: Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (ΔSGNA) increased progressively from 5.2 mV-s {95% confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (ΔHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. Conclusion: Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.

Original languageEnglish (US)
Pages (from-to)149-157
Number of pages9
JournalKorean Circulation Journal
Volume45
Issue number2
DOIs
StatePublished - Mar 1 2015

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Stellate Ganglion
Vagus Nerve Stimulation
Dogs
Heart Rate
Confidence Intervals
Thoracic Nerves
Electrocardiography

Keywords

  • Autonomic nervous system
  • Stellate ganglion
  • Vagus nerve stimulation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Cervical vagal nerve stimulation activates the stellate ganglion in ambulatory dogs. / Rhee, Kyoung Suk; Hsueh, Chia Hsiang; Hellyer, Jessica A.; Park, Hyung Wook; Lee, Young Soo; Garlie, Jason; Onkka, Patrick; Doytchinova, Anisiia T.; Garner, John B.; Pate, Jheel; Chen, Lan; Fishbein, Michael C.; Everett, Thomas; Lin, Shien-Fong; Chen, Peng-Sheng.

In: Korean Circulation Journal, Vol. 45, No. 2, 01.03.2015, p. 149-157.

Research output: Contribution to journalArticle

Rhee, KS, Hsueh, CH, Hellyer, JA, Park, HW, Lee, YS, Garlie, J, Onkka, P, Doytchinova, AT, Garner, JB, Pate, J, Chen, L, Fishbein, MC, Everett, T, Lin, S-F & Chen, P-S 2015, 'Cervical vagal nerve stimulation activates the stellate ganglion in ambulatory dogs', Korean Circulation Journal, vol. 45, no. 2, pp. 149-157. https://doi.org/10.4070/kcj.2015.45.2.149
Rhee, Kyoung Suk ; Hsueh, Chia Hsiang ; Hellyer, Jessica A. ; Park, Hyung Wook ; Lee, Young Soo ; Garlie, Jason ; Onkka, Patrick ; Doytchinova, Anisiia T. ; Garner, John B. ; Pate, Jheel ; Chen, Lan ; Fishbein, Michael C. ; Everett, Thomas ; Lin, Shien-Fong ; Chen, Peng-Sheng. / Cervical vagal nerve stimulation activates the stellate ganglion in ambulatory dogs. In: Korean Circulation Journal. 2015 ; Vol. 45, No. 2. pp. 149-157.
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abstract = "Background and Objectives: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. Materials and Methods: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. Results: Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (ΔSGNA) increased progressively from 5.2 mV-s {95{\%} confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (ΔHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. Conclusion: Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.",
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AU - Rhee, Kyoung Suk

AU - Hsueh, Chia Hsiang

AU - Hellyer, Jessica A.

AU - Park, Hyung Wook

AU - Lee, Young Soo

AU - Garlie, Jason

AU - Onkka, Patrick

AU - Doytchinova, Anisiia T.

AU - Garner, John B.

AU - Pate, Jheel

AU - Chen, Lan

AU - Fishbein, Michael C.

AU - Everett, Thomas

AU - Lin, Shien-Fong

AU - Chen, Peng-Sheng

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Background and Objectives: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. Materials and Methods: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. Results: Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (ΔSGNA) increased progressively from 5.2 mV-s {95% confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (ΔHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. Conclusion: Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.

AB - Background and Objectives: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. Materials and Methods: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. Results: Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (ΔSGNA) increased progressively from 5.2 mV-s {95% confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (ΔHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. Conclusion: Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.

KW - Autonomic nervous system

KW - Stellate ganglion

KW - Vagus nerve stimulation

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