Trial reportJournal of the American Heart Association2021
Low-Level Tragus Stimulation Modulates Atrial Alternans and Fibrillation Burden in Patients With Paroxysmal Atrial Fibrillation.
Trial report in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 35 citations in OpenAlex.
- Remote ischemic conditioning combined with transcutaneous vagus nerve stimulation reduces reperfusion injuries and improves cardiac function in acute ST-segment elevation myocardial infarctions.BMC cardiovascular disorders · 2026Trial
- Trial
- Low-Level Tragus Stimulation Modulates Atrial Alternans and Fibrillation Burden in Patients With Paroxysmal Atrial Fibrillation.Journal of the American Heart Association · 2021Trial
- Prioritizing Discovery and Advancements in Arrhythmia Therapies: NIH/NHLBI Workshop.JACC. Clinical electrophysiology · 2026Review
- Patient-reported effectiveness of strategies to convert paroxysmal atrial fibrillation to sinus rhythm in the home setting - a community-based participatory research approach.BMC cardiovascular disorders · 2026Article
- Autonomic nervous system modulation in arrhythmias: mechanisms and therapeutic advances.Frontiers in physiology · 2026Review
- Autonomic dysregulation and atrial arrhythmias.American journal of physiology. Cell physiology · 2025Review
- Efficacy of Transcutaneous Vagus Nerve Stimulation to Suppress Paroxysmal Atrial Fibrillation: A Systematic Review.Cureus · 2025Review
- Low-level auricular vagus nerve stimulation lowers blood pressure and heart rate in paroxysmal atrial fibrillation patients: a self-controlled study.Frontiers in neuroscience · 2025Article
- Transcutaneous Non-Invasive Vagus Nerve Stimulation: Changing the Paradigm for Stroke and Atrial Fibrillation Therapies?Biomolecules · 2024Review
- The effect of transcutaneous auricular vagus nerve stimulation on cardiovascular function in subarachnoid hemorrhage patients: a safety study.medRxiv : the preprint server for health sciences · 2024Article
- Pathophysiology and clinical relevance of atrial myopathy.Basic research in cardiology · 2024Review
- The Intrinsic Cardiac Nervous System: From Pathophysiology to Therapeutic Implications.Biology · 2024Review
- Non-invasive Neuromodulation of Arrhythmias.The Journal of innovations in cardiac rhythm management · 2024Review
- Vagus Nerve Stimulation and Inflammation in Cardiovascular Disease: A State-of-the-Art Review.Journal of the American Heart Association · 2023Review
- Review
- Targeted Atrial Fibrillation Therapy and Risk Stratification Using Atrial Alternans.Journal of cardiovascular development and disease · 2023Review
- Chronic vagus nerve stimulation in patients with heart failure: challenge or failed translation?Frontiers in cardiovascular medicine · 2023Review
- Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation.Arrhythmia & electrophysiology review · 2023Review
- Promising Therapies for Atrial Fibrillation and Ventricular Tachycardia.International journal of molecular sciences · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Background Low-level tragus stimulation (LLTS) has been shown to significantly reduce atrial fibrillation (AF) burden in patients with paroxysmal AF. P-wave alternans (PWA) is believed to be generated by the same substrate responsible for AF. Hence, PWA may serve as a marker in guiding LLTS therapy. We investigated the utility of PWA in guiding LLTS therapy in patients with AF. Methods and Results Twenty-eight patients with AF were randomized to either active LLTS or sham (earlobe stimulation). LLTS was delivered through a transcutaneous electrical nerve stimulation device (pulse width 200 μs, frequency 20 Hz, amplitude 10-50 mA), for 1 hour daily over a 6-month period. AF burden over 2-week periods was assessed by noninvasive continuous ECG monitoring at baseline, 3 months, and 6 months. A 5-minute control ECG for PWA analysis was recorded during all 3 follow-up visits. Following the control ECG, an additional 5-minute ECG was recorded during active LLTS in all patients. At baseline, acute LLTS led to a significant rise in PWA burden. However, active patients receiving chronic LLTS demonstrated a significant reduction in both PWA and AF burden after 6 months (
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.