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Cervical Vagal Nerve Stimulation Activates the Stellate Ganglion in Ambulatory Dogs
이경석,Chia-Hsiang Hsueh,Jessica A. Hellyer,박형욱,이영수,Jason Garlie,Patrick Onkka,Anisiia T. Doytchinova,John B. Garner,Jheel Patel,Lan S. Chen,Michael C. Fishbein,Thomas Everett 4th,Shien-Fong Lin,Peng-She 대한심장학회 2015 Korean Circulation Journal Vol.45 No.2
Background and Objectives: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significantsympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagalnerve and activate the stellate ganglion. Materials and Methods: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneouselectrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared theSGNA 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, suggestingsympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggestingsimultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNSon 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 to13.7 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 stellateganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.
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