OBJECTIVE: Hypertension is the largest threat to patient health and a burden to health care systems. Despite various options, 30% of patients do not respond sufficiently to medical treatment. Mechanoreceptors in the aortic arch relay blood pressure (BP) levels through vagal nerve (VN) fibers to the brainstem and trigger the baroreflex, lowering the BP. Selective electrical stimulation of these nerve fibers reduced BP in rats. However, there is no technique described to localize and stimulate these fibers inside the VN without inadvertent stimulation of non-baroreceptive fibers causing side effects like bradycardia and bradypnea. APPROACH: We present a novel method for selective VN stimulation to reduce BP without the aforementioned side effects. Baroreceptor compound activity of rat VN (n = 5) was localized using a multichannel cuff electrode, true tripolar recording and a coherent averaging algorithm triggered by BP or electrocardiogram. MAIN RESULTS: Tripolar stimulation over electrodes near the barofibers reduced the BP without triggering significant bradycardia and bradypnea. The BP drop was adjusted to 60% of the initial value by varying the stimulation pulse width and duration, and lasted up to five times longer than the stimulation. SIGNIFICANCE: The presented method is robust to impedance changes, independent of the electrode's relative position, does not compromise the nerve and can run on implantable, ultra-low power signal processors.
OBJECTIVE:Hypertension is the largest threat to patient health and a burden to health care systems. Despite various options, 30% of patients do not respond sufficiently to medical treatment. Mechanoreceptors in the aortic arch relay blood pressure (BP) levels through vagal nerve (VN) fibers to the brainstem and trigger the baroreflex, lowering the BP. Selective electrical stimulation of these nerve fibers reduced BP in rats. However, there is no technique described to localize and stimulate these fibers inside the VN without inadvertent stimulation of non-baroreceptive fibers causing side effects like bradycardia and bradypnea. APPROACH: We present a novel method for selective VN stimulation to reduce BP without the aforementioned side effects. Baroreceptor compound activity of rat VN (n = 5) was localized using a multichannel cuff electrode, true tripolar recording and a coherent averaging algorithm triggered by BP or electrocardiogram. MAIN RESULTS: Tripolar stimulation over electrodes near the barofibers reduced the BP without triggering significant bradycardia and bradypnea. The BP drop was adjusted to 60% of the initial value by varying the stimulation pulse width and duration, and lasted up to five times longer than the stimulation. SIGNIFICANCE: The presented method is robust to impedance changes, independent of the electrode's relative position, does not compromise the nerve and can run on implantable, ultra-low power signal processors.
Authors: David K Piech; Benjamin C Johnson; Konlin Shen; M Meraj Ghanbari; Ka Yiu Li; Ryan M Neely; Joshua E Kay; Jose M Carmena; Michel M Maharbiz; Rikky Muller Journal: Nat Biomed Eng Date: 2020-02-19 Impact factor: 25.671
Authors: Mark W Chapleau; Diane L Rotella; John J Reho; Kamal Rahmouni; Harald M Stauss Journal: Am J Physiol Heart Circ Physiol Date: 2016-05-20 Impact factor: 4.733
Authors: Karsten Heusser; Jens Tank; Julia Brinkmann; Jan Menne; Jessica Kaufeld; Silvia Linnenweber-Held; Joachim Beige; Mathias Wilhelmi; André Diedrich; Hermann Haller; Jens Jordan Journal: Hypertension Date: 2016-02-01 Impact factor: 10.190