Related Experiment Video
Updated: Jul 6, 2026
Laboratory Administration of Transcutaneous Auricular Vagus Nerve Stimulation taVNS: Technique, Targeting, and Considerations
Published on: January 7, 2019
Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Premature Ventricular Contractions: A Crossover,
Stefanos Zafeiropoulos1, Kristie Coleman2, Jonathan Kogan2
1Northwell Cardiovascular Institute, New Hyde Park, New York, USA; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York, USA.
Introduction:
The autonomic nervous system has been implicated in the genesis of idiopathic premature ventricular complexes (PVCs). Antiadrenergic effects have been shown noninvasively by low-level electrical stimulation of the tragus (LLTS).
Objectives:
This study evaluated the efficacy of LLTS in reducing PVC burden.
Methods:
This 2-center, prospective, sham-controlled, single-blinded, crossover randomized clinical trial was conducted in patients with symptomatic PVCs with at least 5% daily PVC burden and who were refractory to medical therapy. Participants received two sequential, 10-day sessions of active LLTS (20 Hz, 1 mA below the discomfort threshold) and sham stimulation (earlobe stimulation). Each treatment was interrupted by an 8-day washout period. Randomization determined the order of treatment. All patients wore an extended Holter monitor (ePatch; Philips) for daily PVC count during the study period.
Results:
Of the 36 randomized patients, 35 (19 [59.4%] male; mean age 58.0 ± 17.1 years) completed the study and were included in the analysis. The median baseline PVC burden was 12.00% (IQR: 11.4%). LLTS significantly reduced the median PVC burden by 13.4% compared with sham stimulation (10.5% [IQR: 14.4%] vs 8.59% [IQR: 8.45%]; P = 0.021). No significant differences in heart rate variability were observed between the 2 groups. Exploratory analyses revealed a more pronounced reduction in slow heart rate-dependent PVCs and a sustained decrease in PVC burden throughout the LLTS period.
Conclusions:
LLTS effectively reduced PVC burden in patients with symptomatic PVCs refractory to medical therapy, highlighting its potential as an adjuvant therapeutic option. Larger, multicenter trials are warranted to confirm these findings and evaluate long-term outcomes [Non-invasive Vagal Stimulation for Frequent Premature Ventricular Complexes (NoVa-PVC); NCT05341544].
