Transcutaneous electrical stimulation of auricular branch of vagus nerve: A noninvasive therapeutic approach for post-ischemic heart failure

  • Wang Z
  • Yu L
  • Chen M
 et al. 
  • 13


    Mendeley users who have this article in their library.
  • 13


    Citations of this article.


The major determinant of survival after recovery from myocardial infarction (MI) is the left ventricular remodeling, which has been strongly associated with clinical outcomes in numerous heart failure (HF) trials [1]. Despite modern reperfusion strategies, patients with myocardial infarction are at higher mortality rate due to tonic sympa-thetic activities that promote HF [2]. It is well known that chronic vagus nerve stimulation (VNS) could suppress the cardiac sympathetic outflow [3], prevent and reverse cardiac remodeling to treat post-myocardial infarction heart failure [4]. However, VNS treatment has to implant neurostimulator system with a bipolar multi-contact cuff electrode around the cervical vagus nerve by surgery and may cause side effects including neck pain, coughing, swallowing difficulty, and voice alteration along with nausea and indigestion [5]. Transcutaneous electrical stimulation of auricular branch of vagus nerve located at the tragus, the anterior protuberance of the outer ear, is a noninvasive approach to enhance vagus nerve activity (Fig. 1). The auricular branch of vagus nerve (ABVN) is the only peripheral branch of the vagus nerve that distributes to the skin. The afferent vagal nerve fiber of ABVN enters the main vagal trunk through the jugular ganglion at level of the skull base. The sensory neurons of ABVN innervating the auricle send their central axons to form direct synapses with nucleus tractus solitarius (NTS) neurons, which is an important neural substrate in the regulation of cardiovascular functions [6]. After receiving the stimulus signals from ABVN, the NTS activates the dorsal motor nucleus of the vagus (DMN) to inhibit the cardiovascular function (Fig. 1). Researchers demonstrated the anatomical relationship between ABVN and NTS by applying horseradish peroxidase (HRP) to the central cut end of the ABVN in the cat [7] and another group found that stimulation at distribution area of auricular vagus nerve could activate the cardiac-related neurons in the NTS to evoke cardiovascular inhibition, whereas the inactivation of the NTS with local anesthetics decreased the cardiovascular inhibitory responses evoked by auricular stimulation [8]. Gao et al. [9] also found acupuncture-like stimulation of ABVN evoked cardiovascular inhibition via activating the cardiac-related neurons in the NTS. Besides, our previous study had proven that transcu-taneous electrical stimulation of auricular branch of vagus nerve had the same effects as invasive cervical vagus nerve stimulation on the inhibition of atrial fibrillation inducibility [10]. It is possible that electric stimulation of ABVN can augment vagal tone by means of activating the afferent vagal

Author-supplied keywords

  • Auricular branch of vagus nerve
  • Heart failure
  • Transcutaneous electrical stimulation

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Get full text


  • Zhuo Wang

  • Lilei Yu

  • Mingxian Chen

  • Songyun Wang

  • Hong Jiang

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free