Medical Research

TAVNS and HRV in Heart Failure Patients

Kristen Sparrow • June 04, 2023

Study using TAVNS (transcutaneous vagal nerve stimulation) in patients with heart failure showed improved autonomic balance and lifestyle measures with TAVNS after 20 sessions, 30 min ea

This study looked at a group of patients with heart failure.  They were divided into two groups: sham TAVNS and 5hz/15hz.  TAVNS.  They all received 30 minute treatment, 5 days per week for a total of 20 sessions.  Analysis was completed after that.  They found that in the verum treatment group, they improved their HRV and also their quality of life scores.  There was no difference in the control group.

The authors point out that lower HRV is associated with an increase in sudden death in patients with heart failure.  They postulate that TAVNS, a noninvasive means of increasing HRV could be beneficial in heart failure patients.

Couceiro SM, Sant’Anna LB, Sant’Anna MB, Menezes RSM, Mesquita ET, Sant’Anna FM. Auricular Vagal Neuromodulation and its Application in Patients with Heart Failure and Reduced Ejection Fraction. Arq Bras Cardiol. 2023 May 15;120(5):e20220581. Portuguese, English. doi: 10.36660/abc.20220581. PMID: 37194830.  full article here


Background: The autonomic nervous system (ANS) imbalance in heart failure (HF) creates a vicious cycle, excess sympathetic activity, and decreased vagal activity contributing to the worsening of HF. Low-intensity transcutaneous electrical stimulation of the auricular branch of the vagus nerve (taVNS) is well tolerated and opens new therapeutic possibilities.

Objectives: To hypothesize the applicability and benefit of taVNS in HF through intergroup comparison of echocardiography parameters, 6-minute walk test, Holter heart rate variability (SDNN and rMSSD), Minnesota quality of life questionnaire, and functional class by the New York Heart Association. In comparisons, p values <0.05 were considered significant.

Methods: Prospective, double-blind, randomized clinical study with sham methodology, unicentric. Forty-three patients were evaluated and divided into 2 groups: Group 1 received taVNS (frequencies 2/15 Hz), and Group 2 received sham. In comparisons, p values <0.05 were considered significant.

Results: In the post-intervention phase, it was observed that Group 1 had better rMSSD (31 x 21; p = 0.046) and achieved better SDNN (110 vs. 84, p = 0.033). When comparing intragroup parameters before and after the intervention, it was observed that all of them improved significantly in group 1, and there were no differences in group 2.

Conclusion: taVNS is a safe to perform and easy intervention and suggests a probable benefit in HF by improving heart rate variability, which indicates better autonomic balance. New studies with more patients are needed to answer the questions raised by this study.