CONTROL OF CARDIAC ARRHYTHMIA BY VAGAL STIMULATION AT THE ATRIOVENTRICULAR AND SINOATRIAL NODAL FAT PADS OF THE HEART

摘要

Vagal stimulation applied to the atrioventricular nodal ("AVN") fat pad and the sinoatrial nodal ("SAN") fat pad via epicardial leads is useful for controlling cardiac arrhythmia, including atrial fibrillation ('AF"). In the case of AF, for example, vagal stimulation may be applied initially to the AVN fat pad to reduce ventricular rate, and vagal stimulation may be applied to the SAN fat pad after restoration of sinus rhythm to control atrial rate. The technique is applicable to control acute AF and chronic AF. The vagal stimulation may be optimized for exciting ganglia in the fat pads to produce dromotropic and chronotropic effects in the atrioventricular node and the sinoatrial node, respectively. In addition, the SAN fat lead can also be used to pace the atrium in case of sinus bradycardia.