The DOI matches its Crossref record; 73 of the 73 references it cites were found in a registry or an index.
Vagal stimulation and prevention of sudden death in conscious dogs with a healed myocardial infarction.
Open accessAbstract
The interest for the antifibrillatory effect of vagal stimulation has been largely limited by the fact that this concept seemed restricted to acute experiments in anesthetized animals. To explore the potentially protective role of vagal stimulation in conscious animals we developed a chronically implantable device to be placed around the cervical right vagus. An anterior myocardial infarction was produced in 161 dogs; 1 month later an exercise stress test was performed on the 105 survivors. Toward the end of the test the circumflex coronary artery was occluded for 2 minutes. Fifty-nine (56%) dogs developed ventricular fibrillation and, before this test was repeated, were assigned either to a control group (n = 24) or to be instrumented with the vagal device (n = 35). Five dogs were excluded because of electrode malfunction. Compared with the heart rate level attained after 30 seconds of occlusion during exercise in the control test, vagal stimulation led to a decrease of approximately 75 beats/min (from 255 +/- 33 to 170 +/- 36 beats/min, p less than 0.001). In the control group 22 (92%) of 24 dogs developed ventricular fibrillation during the second exercise and ischemia test. By contrast, during vagal stimulation ventricular fibrillation occurred in only 3 (10%) of the 30 dogs tested and recurred in 26 (87%) during an additional exercise and ischemia test in the control condition (p less than 0.001 versus the vagal stimulation test; internal control analysis). Combined analysis of the tests performed in the control condition showed that ventricular fibrillation was reproducible in 48 (89%) of the 54 dogs tested. The protective effect of vagal stimulation was also significant in the group comparison analysis and even after exclusion of those four dogs in which ventricular fibrillation was not reproducible (92% versus 11.5%, control versus vagal stimulation, p less than 0.001). When heart rate was kept constant by atrial pacing, the vagally mediated protection was still significant (p = 0.015) as five (55%) of nine dogs survived the test. This study shows that vagal stimulation, performed shortly after the onset of an acute ischemic episode in conscious animals with a healed myocardial infarction, can effectively prevent ventricular fibrillation. This striking result seems to depend on multiple mechanisms having a synergistic action. The decrease in heart rate is an important but not always essential protective mechanism. The electrophysiological effects secondary to the vagally mediated antagonism of the sympathetic activity on the heart are likely to play a major role.
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“In particular, post-exercise recovery is a critical phase for sudden cardiovascular events, predominantly in the 30 minutes immediately following vigorous exercise, 5 which is attributable to increased sympathetic and decreased parasympathetic nerve activity.6”
From Caffeine delays autonomic recovery following acute exercise (2015) · cites this paper as [6]
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Metadata
- Authors
- Vanoli, E., De Ferrari, G. M., Stramba-Badiale, M., Hull, S. S., Foreman, R. D., & Schwartz, P. J.
- Affiliations
- University of Oklahoma (US)
- Department of Physiology and Biophysics, University of Oklahoma, Oklahoma City.
- Venue
- Circulation Research
- Published
- 1991-05
- Volume
- 68
- Issue
- 5
- Pages
- 1471-1481
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- OpenAlex
- W2123181530
- Cited by
- 681
- References
- 73
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 10 · 2023: 22 · 2022: 18 · 2021: 19 · 2020: 20 · 2019: 23 · 2018: 16 · 2017: 22 · 2016: 29 · 2015: 42 · 2014: 35 · 2013: 28 · 2012: 25
- FWCI
- 8.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- National Institutes of Health (5p01hl033727-03)
- National Heart, Lung, and Blood Institute (HL33727)
- Topics
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- vagus nerve stimulation, sudden cardiac death prevention, ventricular fibrillation, myocardial infarction, anterior myocardial infarction, coronary artery occlusion, exercise stress testing, heart rate reduction, atrial pacing, conscious dogs, ischemia-induced arrhythmia, antifibrillatory effect, atrial fibrillation prevention
- MeSH terms
- Animals, Blood Pressure, Cardiac Pacing, Artificial, Death, Sudden, Dogs, Electric Stimulation, Electrocardiography, Heart Rate, Hemodynamics, Myocardial Infarction, Vagus Nerve, Ventricular Fibrillation
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