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Transcutaneous low-level tragus electrical stimulation suppresses AF
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In patients with paroxysmal atrial fibrillation, transcutaneous low-level tragus electrical stimulation appears to inhibit atrial fibrillation and reduce inflammatory cytokines, according to a study published in the Journal of the American College of Cardiology.
Researchers evaluated 40 patients with paroxysmal AF who were referred to the electrophysiology laboratory at the University of Oklahoma Health Sciences Center.
Patients were randomly assigned to undergo low-level transcutaneous electrical stimulation (LLTS; n = 20) or sham treatment (n = 20). The mean patient age of the LLTS group was 60.9 ± 7.8 years, and the mean age of the control group was 62.9 ± 9.8 years. The LLTS group was 75% male (n = 15) and the sham group was 55% male (n = 11).
LLTS was performed through stimulation of the right ear tragus by attachment of a flat metal clip. The threshold for setting the LLTS in each participant was established based on the lowest voltage needed to slow the sinus rate or prolong the atrial-His (AH) interval.
The researchers found that the duration of pacing-induced AF was reduced significantly from baseline by 6.3 ± 1.9 min in the LLTS group, but not in the control group (P = .002 for comparison). AF cycle length was significantly increased from baseline by 28.8 ± 6.5 ms in the LLTS group, but not in the control group (P = .0002 for comparison). The LLTS group only demonstrated a significant decrease in systemic but not coronary sinus tumor necrosis factor-alpha and C-reactive protein levels.
According to the researchers, these findings are the first to show in humans that the duration and inducibility of AF, as well as inflammatory cytokines, can be inhibited noninvasively through LLTS.
“Our results support the notion that autonomic neuromodulation may emerge as an alternative nonpharmacological, non-ablative modality to treat paroxysmal AF,” the researchers wrote. “Further studies in ambulatory patients are warranted.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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