2017-997 Neural Modulation of Autonomic Nervous System to Alter Memory and Plasticity of the Autonomic Network

SUMMARY:

Researchers at UCLA from the Departments of Medicine and Bioengineering have created a device that modulates the autonomic nervous system to treat heart conditions like arrhythmias.

BACKGROUND:

The autonomic nervous system controls unconscious bodily functions like breathing and maintaining heart function. The cardiac autonomic nervous system includes the Vagus nerve and intrinsic cardiac nervous system. Modulating this system can provide therapeutic effects such as preventing cardiac arrhythmias (improper beating of the heart). Currently, pharmacological treatments, ablation therapies, and cardioversion (defibrillation) are used to treat arrhythmias like atrial fibrillation. Drug treatments have side effects (e.g. nausea, breathing problems) and can build a tolerance over time. Ablation and cardioversion usually require repeat procedures, can potentially lead to further complications like stroke, and still requires the use of medication after the procedure. Modulation of the autonomic nervous system provides a new avenue to treat heart conditions in patients where current treatments do not work.

INNOVATION:

Researchers from the Departments of Medicine and Bioengineering have created a device that modulates the autonomic nervous system to treat heart conditions like arrhythmias. The device electrically stimulates the Vagus nerve to control heart function. In a canine study, stimulation of the Vagus nerve either prevented atrial fibrillation or dampened its effect 75% of the time and prevented further arrhythmias by reorganizing the autonomic nervous system. This success rate is comparable to the high success rate of ablation therapies, but without the side effects or the need for subsequent medication. This strategy has also been shown to work in other cardiac complications. In a guinea pig study, vagal nerve stimulation prevented maladaptive changes in cardiac structure and function seen after chronically overloading the heart.

POTENTIAL APPLICATIONS:

• Prevention of arrhythmias/atrial fibrillations
• Creates changes in the autonomic nervous system that can:
• Modulate heart activity after traumatic events like heart attack to prevent further and compounding complications
• Prevent maladaptive heart changes after traumatic events or from progressive heart complications
• Can also be used to also treat epilepsy and depression

ADVANTAGES:

• Rapid therapeutic onset
• Can be reversible (unlike ablation)
• Effects last even after treatment is over
• Can be used for a variety of heart conditions, including progressive ones
• Has been shown to have beneficial effects in epilepsy and depression

RELATED MATERIALS:

• Salavation et al. Vagal stimulation targets select populations of intrinsic cardiac neurons to control neurally induced atrial fibrillation. Am J Physiol Heart Circ Physiol 311:H1311-H1320, 2016.
• Beaumont et al. Vagus nerve stimulation mitigates intrinsic neuronal remodeling and cardiac hypertrophy induced by chronic pressure overload in guinea pig, Am J Physiol Heart Circ Physiol 310:H1349-H1359, 2016.