Heart function influenced by selective mid-cervical left vagus nerve stimulation in a human case study

Rozman, Janez; Pečlin, Polona; Kneževič, Ivan; Mirkovic̆, Tomislav; Geršak, Borut; Podbregar, Matej

doi:10.1038/hr.2009.140

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…The conduction velocity of adult vagal fibers as measured in that study is 12 m s −1 , which is slower than the 19 m s −1 measured by Evans et al (2004). Rozman et al (2009) report influences on the heart function of cervical left vagus stimulation in a single human subject. They show that to elicit a significant effect, a current that is above 1.5 mA but below 2.5 mA is needed.…”

Section: Discussioncontrasting

confidence: 54%

Recruitment and blocking properties of the CardioFit stimulation lead

2011

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The CardioFit vagal stimulation system has been developed as a proposed therapy for congestive heart failure (CHF). CardioFit is to be implanted in several hundred CHF patients enrolled in the INOVATE-HF clinical trial, an FDA approved study. The CardioFit stimulation lead (CSL), which is a cuff electrode that delivers stimulation pulses to the right cervical vagus, was designed to recruit efferent cardiac vagal fibers while minimizing unwanted recruitment of other fibers. This paper presents the CSL and measurements of its recruiting and blocking properties when placed on isolated porcine vagus nerves maintained at an elevated temperature in oxygenated artificial cerebrospinal fluid. Using charge balanced quasi-trapezoidal pulses driven through the CSL, we show in eight out of nine nerves a 63% ± 13% (mean ± SD) unidirectional attenuation of the A-fiber compound action potential attained at a current of 3.0 ± 0.8 mA. The threshold for the activation of A- and B-fibers was found to be 0.3 ± 0.17 mA and 2.5 ± 1.1 mA, respectively. The results presented here should help to guide the optimal parameters used in the upcoming deployment of the CardioFit system.

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Section: Discussioncontrasting

confidence: 54%

Recruitment and blocking properties of the CardioFit stimulation lead

2011

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“…1 A shows the conceptual neuromodulation of long-lived bioimplanted SiC electronics to recover critical communication between the central nervous system and neuromuscular junctions. The system, via electronics-nerve interfaces, has potential as a long-term, therapeutic modality for movement restoration from chronic motor-based disorders, such as muscle/nerve stimulations for peripheral nerve regeneration and vagal modulations for treatments of heart conditions (e.g., hypertension and heart failure) ( 29 ), epileptic seizure ( 30 ), and depression ( 31 ). Desired features include well-matched mechanical flexibility with soft tissue, together with the capabilities of bioelectronic modality for neuron stimulation and real-time biophysical sensing ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…neuromuscular junctions. The system, via electronics/nerve interfaces, has potential for longterm, therapeutic modality for restoration of chronic motor-based disorders, such as muscle/nerve stimulations for peripheral nerve regeneration and vagal modulations for treatments of heart conditions (hypertension and heart failure) 27 , epileptic seizure 28 , and depression 29 . An ideal platform would provide well-matched mechanical properties with soft tissue together with the capabilities of offering electrochemical functions for Faradaic interface to deliver useful neuron stimulation and/or recording, Figure 1 Nanothin SiC films were deposited on a Si substrate using a chemical vapor deposition process inside a hot wall chamber at a low pressure 30,31 .…”

Section: Introductionmentioning

confidence: 99%

Wide bandgap semiconductor nanomembranes as a long-term biointerface for flexible, implanted neuromodulator

Nguyen

Barton

Ashok

et al. 2022

Proc. Natl. Acad. Sci. U.S.A.

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Electrical neuron stimulation holds promise for treating chronic neurological disorders, including spinal cord injury, epilepsy, and Parkinson’s disease. The implementation of ultrathin, flexible electrodes that can offer noninvasive attachment to soft neural tissues is a breakthrough for timely, continuous, programable, and spatial stimulations. With strict flexibility requirements in neural implanted stimulations, the use of conventional thick and bulky packages is no longer applicable, posing major technical issues such as short device lifetime and long-term stability. We introduce herein a concept of long-lived flexible neural electrodes using silicon carbide (SiC) nanomembranes as a faradic interface and thermal oxide thin films as an electrical barrier layer. The SiC nanomembranes were developed using a chemical vapor deposition (CVD) process at the wafer level, and thermal oxide was grown using a high-quality wet oxidation technique. The proposed material developments are highly scalable and compatible with MEMS technologies, facilitating the mass production of long-lived implanted bioelectrodes. Our experimental results showed excellent stability of the SiC/silicon dioxide (SiO 2 ) bioelectronic system that can potentially last for several decades with well-maintained electronic properties in biofluid environments. We demonstrated the capability of the proposed material system for peripheral nerve stimulation in an animal model, showing muscle contraction responses comparable to those of a standard non-implanted nerve stimulation device. The design concept, scalable fabrication approach, and multimodal functionalities of SiC/SiO 2 flexible electronics offer an exciting possibility for fundamental neuroscience studies, as well as for neural stimulation–based therapies.

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“…To simulate BP and HR VNS responses, we developed a model using both human [4,8,9] and murine [11,12] BP, HR and VNS treatment parameters, and an analog simulation format based on Fig. 1, to reveal stable and unstable responses, state-of-the-heart transitions, and responses to simulated therapeutic inputs.…”

Section: Simulated Cardiovascular Response To Vns Device Frequency Oumentioning

confidence: 99%

Vagus Nerve Stimulation for Blood Pressure and Heart Rate Regulation

O'Clock

KenKnight

Tolkacheva

2018

2018 Design of Medical Devices Conference

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For more than 27 years, implanted vagus nerve stimulation (VNS) devices, with electric current outputs in the 1 to 3.5 mA range, have been developed for many health care applications, including epilepsy and heart disease [1]. Mechanical compression approaches for VNS were administered under surgical conditions, using forceps, in the 1800’s [2]. Outcomes such as Electrocardiogram (ECG) data, blood pressure (BP), and heart rate (HR) were evaluated. Also, non-invasive (NI) mechanical compression of the vagus nerve for various nervous system disorders using hand, thumb, finger and belt pressure was popular in the 1800’s [3]. Cyberonics (now LivaNova) received the first FDA clearance for a surgically implanted electrical VNS device to treat refractory epilepsy in 1997.

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Heart function influenced by selective mid-cervical left vagus nerve stimulation in a human case study

Cited by 8 publications

References 7 publications

Recruitment and blocking properties of the CardioFit stimulation lead

Recruitment and blocking properties of the CardioFit stimulation lead

Wide bandgap semiconductor nanomembranes as a long-term biointerface for flexible, implanted neuromodulator

Vagus Nerve Stimulation for Blood Pressure and Heart Rate Regulation

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