Earmuffs on your ears. But not to hear music. Through a clip, these devices could become a sort of “regulator” for the vagus nerve, the longest in the body, when the heart starts beating wildly as soon as you stand up. The “tailor-made” stimulus for this nervous branch, which also helps regulate the heartbeat, could in the future become a therapy for those suffering from POTS or postural orthostatic tachycardia syndrome. The problem mainly affects women (around 9 out of ten patients) and heavily affects the quality of life, given that when you stand upright after lying or sitting, your heart seems to go crazy. With the appearance of tachycardia, palpitations and even a feeling of dizziness.
Numbers on the rise
In recent times, also thanks to the pandemic Covid-19 and the role of “trigger” that a viral infection can have in determining the pathology, pictures of this type appear to be on the increase. An original study conducted by experts at the University of Oklahoma, coordinated by Stavros StavrakisPublished on JACC: Clinical Electrofisiologyjournal of the American College of Cardiology.
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A pathology that must be recognized
“POTS is highly debilitating, with a major impact on the quality of life and working capacity: it is characterized by severe tachycardia in orthostatism and intolerance to orthostatism, which is accompanied by a variety of disorders, not only cardiac, but also neurological and immunological – he explains Savina Nodari, professor of Cardiology at the University of Brescia. The most common symptoms are dizzinessasthenia, palpitations, dyspnea, chest pain, syncope, paresthesia in the hands and feet, sweating, nausea and abdominal pain. Given the heterogeneous nature of this syndrome, it is very important to make a correct diagnosis between the various forms in order to attenuate or correct the clinical manifestations”. The picture is not uncommon. The prevalence in the general population is between 0.2% and 1 % according to estimates reported in the literature. In over 80% of cases it afflicts young adults between 18 and 49 years of age and in more than 90% these are women. “Attention: it should be remembered that the syndrome also long-Covid presents POTS among the possible disorders that persist after infection with the Sars-CoV-2 virus, even after many months – points out the expert”.
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How the treatment works
The possible action on the vagus nerve basically helps to control the rhythm of the heart (as well as influencing digestion and breathing rate). And for this reason it represents an extremely interesting working hypothesis. The study, in particular, examined a small number of young women, with an average age of 34 years. In 12 of them one was fixed to the auricular cartilage clip active and therefore delivering the stimulus, in 14 the same clip was placed without any action. The check on postural tachycardia was carried out at the beginning of the research and two months later, on the same occasions also checking the electrocardiogram for five minutes and some inflammation parameters, such as cytokines in the blood. After two months of treatment the postural tachycardia was significantly reduced in the treated group, with an average increase in heart rate of 17.6 beats when the women stood up, compared to an average increase of 31.7 beats observed in the population of the placebo group. Cytokines were also lower in the treated group, indicating a decrease in inflammation. and even a decrease in adrenaline was seen.
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A hope for the future
“”Neurovegetative dysautonomy is often at the basis of this picture: for this reason there is a rationale in trying to find a pharmacological or non-pharmacological intervention modality to obtain a greater sympathetic-vagal balance, therefore to increase the vagal tone – comments Nodari. The study tested a non-invasive vagal stimulation system, with a scientifically correct methodology. And it suggests promising results”. But we are only at the beginning. As the authors confirm, these are data that must be confirmed by studies conducted on a larger series of cases. The important thing is to open a glimmer of light towards a possible new therapeutic approach of which is certainly also needed to treat patients who may become further complicated.The pathology has a heavy impact on the quality of life, greatly limiting the possibilities of movement of those who suffer from it and therefore favoring the development of a sedentary lifestyle, weight gain and other metabolic problems , which contribute to worsening the cardiovascular picture.
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