J Appl Biomed 19:133-141, 2021 | DOI: 10.32725/jab.2021.012

Acute effect of spinal cord stimulation on autonomic nervous system function in patients with heart failure

Jan Naar1, *, Deborah Jaye2, Petr Neužil1, Petr Doškář1, Filip Málek1, Bengt Linderoth3, Göran Lind3, Marcus Ståhlberg3
1 Na Homolce Hospital, Department of Cardiology, Prague, Czech Republic
2 Medtronic Plc, Cardiac Rhythm and Heart Failure, Minneapolis, USA
3 Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden

Aims: To test the hypothesis that spinal cord stimulation (SCS) acutely improves heart rate variability (HRV) and baroreceptor sensitivity (BRS) in patients with heart failure (HF).

Methods: SCS (15 minutes) was delivered in four different settings: 90% of maximal tolerated stimulation amplitude (MTA) targeting the T1-T4 spinal cord segments (SCS90T1-4), 60% of MTA (SCS60T1-4), 90% of MTA with cranial (SCS90CR) and caudal (SCS90CA) electrode configuration. HRV and BRS were recorded continuously and stimulation was compared to device off.

Results: Fifteen HF patients were included. SCS90T1-4 did not change the standard deviation of intervals between normal beats (SDNN, p = 0.90), BRS (p = 0.55) or other HRV parameters. In patients with baseline SDNN <50 ms, SCS90T1-4 significantly increased SDNN (p = 0.004).

Conclusions: Acute SCS at 60-90% of MTA targeting upper thoracic spinal cord segments does not improve autonomic balance or baroreceptor sensitivity in unselected patients with heart failure but may improve HRV in patients with low SDNN.

Keywords: Baroreceptor sensitivity; Heart failure; Heart rate variability; Spinal cord stimulation
Grants and funding:

This work was supported by the Ministry of Health, Czech Republic, conceptual development of research organization (NHH, 00023884), Stockholm County Council, Sweden (Project#: 108105) and an institutional research grant from Medtronic, Plc.

Conflicts of interest:

The authors Jan Naar, Petr Neužil, Petr Doškář, Filip Málek, Bengt Linderoth and Göran Lind declare that they have no conflict of interests. Deborah Jaye is an employee of Medtronic, Plc. Marcus Ståhlberg has received speakers’ honorarium from Medtronic, Plc.

Received: October 8, 2020; Revised: April 17, 2021; Accepted: May 5, 2021; Prepublished online: May 18, 2021; Published: September 17, 2021  Show citation

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Naar J, Jaye D, Neužil P, Doškář P, Málek F, Linderoth B, et al.. Acute effect of spinal cord stimulation on autonomic nervous system function in patients with heart failure. J Appl Biomed. 2021;19(3):133-141. doi: 10.32725/jab.2021.012. PubMed PMID: 34907756.
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