Tragus Nerve Stimulation Attenuates Postural Orthostatic Tachycardia Syndrome in Post COVID-19 Infection

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-02-27 DOI:10.1002/clc.70110

Zhuo Wang, Tongjian Zhu, Xuping Li, Xin Lai, Mingxian Chen

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Abstract

Background

Postural orthostatic tachycardia syndrome (POTS) is characterized by symptoms of orthostatic intolerance and is frequently observed in post-COVID conditions.

Objectives

We conducted controlled, prospective, and randomized clinical trials to explore the potential therapeutic benefits of low-level tragus stimulation (LL-TS) in patients with POTS following COVID-19 infection.

Methods

This study enrolled 57 participants with confirmed post-acute COVID-19 who had been diagnosed with POTS. The ear clip was attached to the right tragus of the patients for stimulation (20 Hz with a 1-ms duration) or sham stimulation. They were divided into two groups: the sham LL-TS group (sham stimulation, n = 26) and the LL-TS group (stimulation for 1 month, n = 31). LL-TS was performed 1 h twice daily for 1 month. Postural tachycardia was evaluated at baseline, 1-month visit, and 1-year visit. Heart rate variability (HRV) and plasma neuropeptide Y (NPY) were evaluated at respective time points.

Results

The mean age of participants was 31.9 ± 7.2 years (61.4% female). LL-TS significantly attenuated the increase in heart rate from supine to a 10-min stand, as well as the average and maximum heart rates after 1 month of treatment. LL-TS also significantly reduced NPY levels. In addition, LL-TS significantly increased the high frequency (HF), but decreased the low frequency (LF) and LF/HF ratio during the postural test (all p < 0.01). These effects persisted during the 1-year follow-up.

Conclusion

LL-TS may be a promising therapeutic approach for attenuating autonomic imbalance in patients with POTS following COVID-19 infection.

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耳屏神经刺激可减轻COVID-19感染后体位性心动过速综合征

体位性直立性心动过速综合征（POTS）以直立性不耐受症状为特征，常见于covid - 19后患者。我们开展了对照、前瞻性和随机临床试验，探讨低水平耳屏刺激（LL-TS）对COVID-19感染后POTS患者的潜在治疗效果。方法本研究招募了57名确诊为急性后COVID-19并被诊断为POTS的参与者。将耳夹固定在患者的右耳屏上进行刺激（20 Hz，持续时间1 ms）或假刺激。将其分为两组：假性LL-TS组（假性刺激，n = 26）和LL-TS组（刺激1个月，n = 31）。l - ts每日2次，每次1 h，连续1个月。在基线、1个月随访和1年随访时评估体位性心动过速。心率变异性（HRV）和血浆神经肽Y （NPY）在各自的时间点进行评估。结果参与者平均年龄为31.9±7.2岁，其中女性占61.4%。LL-TS显著降低了从仰卧到站立10分钟的心率增加，以及治疗1个月后的平均和最大心率。LL-TS也显著降低了NPY水平。此外，在体位测试中，LL-TS显著提高了高频（HF），但降低了低频（LF）和LF/HF比值（p < 0.01）。这些影响在1年的随访中持续存在。结论LL-TS可能是一种很有前景的治疗方法，可以减轻COVID-19感染后POTS患者的自主神经失衡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.