Vagus Nerve Stimulation and the Cardiovascular System

Overview

Journal Cold Spring Harb Perspect Med

Specialty General Medicine

Date 2019 May 22

PMID 31109966

Citations 71

Authors

Michael J Capilupi

Samantha M Kerath

Lance B Becker

Affiliations

Soon will be listed here.

Abstract

The vagus nerve plays an important role in maintaining physiological homeostasis, which includes reflex pathways that regulate cardiac function. The link between vagus nerve activity and the high-frequency component of heart rate variability (HRV) has been well established, correlating with vagal tone. Recently, vagus nerve stimulation (VNS) has been investigated as a therapeutic for a multitude of diseases, such as treatment-resistant epilepsy, rheumatoid arthritis, Crohn's disease, and asthma. Because of the vagus nerve's innervation of the heart, VNS has been identified as a potential therapy for cardiovascular disorders, such as cardiac arrest, acute myocardial infarction, and stroke. Here, we review the current state of preclinical and clinical studies, as well as the potential application of VNS in relation to the cardiovascular system.

Citing Articles

Non-Invasive Auricular Vagus Nerve Stimulation Decreases Heart Rate Variability Independent of Caloric Load.

Kaduk K, Petrella A, Muller S, Koenig J, Kroemer N Psychophysiology. 2025; 62(2):e70017.

PMID: 40007175 PMC: 11862327. DOI: 10.1111/psyp.70017.

Corticosteroid-Induced Sinus Bradycardia in a Dog with Systemic Lupus Erythematosus: A Case Report.

Tsou F, Lim E, Jann P, Liu P Animals (Basel). 2025; 15(3).

PMID: 39943145 PMC: 11816077. DOI: 10.3390/ani15030375.

Feasibility of trancutaneous auricular vagus nerve stimulation in Black and Hispanic/Latino people with peripheral neuropathy.

Wong M, Widerstrom-Noga E, Bolanos J, Gonzalez G, Penedo F, Hosein P Front Pain Res (Lausanne). 2025; 5:1516196.

PMID: 39896735 PMC: 11782131. DOI: 10.3389/fpain.2024.1516196.

Research hotspots and frontiers of vagus nerve stimulation in stroke: a bibliometric analysis.

Liu M, Liu M, Zhang B, Fang M, Chen K, Zhang Y Front Neurosci. 2024; 18:1510658.

PMID: 39723424 PMC: 11668697. DOI: 10.3389/fnins.2024.1510658.

Acute exercise impacts heart rate variability but not cognitive flexibility during subsequent simulated firefighter occupational tasks.

Agostinelli P, Bordonie N, Linder B, Robbins A, Jones P, Reagan L Eur J Appl Physiol. 2024; .

PMID: 39537898 DOI: 10.1007/s00421-024-05650-9.

References

Ovbiagele B, Goldstein L, Higashida R, Howard V, Johnston S, Khavjou O . Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association. Stroke. 2013; 44(8):2361-75. DOI: 10.1161/STR.0b013e31829734f2. View

Morishita K, Costantini T, Eliceiri B, Bansal V, Coimbra R . Vagal nerve stimulation modulates the dendritic cell profile in posthemorrhagic shock mesenteric lymph. J Trauma Acute Care Surg. 2014; 76(3):610-7. DOI: 10.1097/TA.0000000000000137. View

Borovikova L, Ivanova S, Zhang M, Yang H, Botchkina G, Watkins L . Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature. 2000; 405(6785):458-62. DOI: 10.1038/35013070. View

Hamann J, Ruble S, Stolen C, Wang M, Gupta R, Rastogi S . Vagus nerve stimulation improves left ventricular function in a canine model of chronic heart failure. Eur J Heart Fail. 2013; 15(12):1319-26. PMC: 3895958. DOI: 10.1093/eurjhf/hft118. View

Schmitt J, Duray G, Gersh B, Hohnloser S . Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. Eur Heart J. 2008; 30(9):1038-45. DOI: 10.1093/eurheartj/ehn579. View

Hays S, Ruiz A, Bethea T, Khodaparast N, Carmel J, Rennaker 2nd R . Vagus nerve stimulation during rehabilitative training enhances recovery of forelimb function after ischemic stroke in aged rats. Neurobiol Aging. 2016; 43:111-8. PMC: 5206764. DOI: 10.1016/j.neurobiolaging.2016.03.030. View

Han S, Kobayashi K, Joung B, Piccirillo G, Maruyama M, Vinters H . Electroanatomic remodeling of the left stellate ganglion after myocardial infarction. J Am Coll Cardiol. 2012; 59(10):954-61. PMC: 3975658. DOI: 10.1016/j.jacc.2011.11.030. View

Hays S, Khodaparast N, Ruiz A, Sloan A, Hulsey D, Rennaker 2nd R . The timing and amount of vagus nerve stimulation during rehabilitative training affect poststroke recovery of forelimb strength. Neuroreport. 2014; 25(9):676-82. PMC: 4039714. DOI: 10.1097/WNR.0000000000000154. View

Brack K, Patel V, Coote J, Ng G . Nitric oxide mediates the vagal protective effect on ventricular fibrillation via effects on action potential duration restitution in the rabbit heart. J Physiol. 2007; 583(Pt 2):695-704. PMC: 2277035. DOI: 10.1113/jphysiol.2007.138461. View

10.

Meyers E, Solorzano B, James J, Ganzer P, Lai E, Rennaker 2nd R . Vagus Nerve Stimulation Enhances Stable Plasticity and Generalization of Stroke Recovery. Stroke. 2018; 49(3):710-717. PMC: 6454573. DOI: 10.1161/STROKEAHA.117.019202. View

11.

Savarese G, Lund L . Global Public Health Burden of Heart Failure. Card Fail Rev. 2017; 3(1):7-11. PMC: 5494150. DOI: 10.15420/cfr.2016:25:2. View

12.

Ronson R, Puskas J, Thourani V, Velez D, Bufkin B, Glass J . Controlled intermittent asystole cardiac therapy induced by pharmacologically potentiated vagus nerve stimulation in normal and hibernating myocardium. Ann Thorac Surg. 2003; 75(6):1929-36. DOI: 10.1016/s0003-4975(03)00115-2. View

13.

Rezende-Neto J, Alves R, Carvalho Jr M, Almeida T, Trant C, Kushmerick C . Vagus nerve stimulation improves coagulopathy in hemorrhagic shock: a thromboelastometric animal model study. J Trauma Manag Outcomes. 2014; 8:15. PMC: 4169132. DOI: 10.1186/1752-2897-8-15. View

14.

Kimberley T, Pierce D, Prudente C, Francisco G, Yozbatiran N, Smith P . Vagus Nerve Stimulation Paired With Upper Limb Rehabilitation After Chronic Stroke. Stroke. 2018; 49(11):2789-2792. DOI: 10.1161/STROKEAHA.118.022279. View

15.

Weisfeldt M, Becker L . Resuscitation after cardiac arrest: a 3-phase time-sensitive model. JAMA. 2002; 288(23):3035-8. DOI: 10.1001/jama.288.23.3035. View

16.

Xie X, Lee S, Johnson C, Ippolito J, KenKnight B, Tolkacheva E . Intermittent vagal nerve stimulation alters the electrophysiological properties of atrium in the myocardial infarction rat model. Annu Int Conf IEEE Eng Med Biol Soc. 2015; 2014:1575-8. DOI: 10.1109/EMBC.2014.6943904. View

17.

Yu L, Scherlag B, Sha Y, Li S, Sharma T, Nakagawa H . Interactions between atrial electrical remodeling and autonomic remodeling: how to break the vicious cycle. Heart Rhythm. 2012; 9(5):804-9. DOI: 10.1016/j.hrthm.2011.12.023. View

18.

Kondelkova K, Vokurkova D, Krejsek J, Borska L, Fiala Z, Ctirad A . Regulatory T cells (TREG) and their roles in immune system with respect to immunopathological disorders. Acta Medica (Hradec Kralove). 2010; 53(2):73-7. DOI: 10.14712/18059694.2016.63. View

19.

Chen M, Yu L, Liu Q, Wang Z, Wang S, Jiang H . Low level tragus nerve stimulation is a non-invasive approach for anti-atrial fibrillation via preventing the loss of connexins. Int J Cardiol. 2014; 179:144-5. DOI: 10.1016/j.ijcard.2014.10.114. View

20.

Nearing B, Libbus I, Amurthur B, KenKnight B, Verrier R . Acute Autonomic Engagement Assessed by Heart Rate Dynamics During Vagus Nerve Stimulation in Patients With Heart Failure in the ANTHEM-HF Trial. J Cardiovasc Electrophysiol. 2016; 27(9):1072-7. DOI: 10.1111/jce.13017. View