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Randomized Controlled Trial
. 2013 Nov 12;8(11):e79438.
doi: 10.1371/journal.pone.0079438. eCollection 2013.

Acute electromyostimulation decreases muscle sympathetic nerve activity in patients with advanced chronic heart failure (EMSICA Study)

Marc Labrunée  1 , Fabien Despas, Philippe Marque, Thibaut Guiraud, Michel Galinier, Jean Michel Senard, Atul Pathak
Affiliations
Randomized Controlled Trial

Acute electromyostimulation decreases muscle sympathetic nerve activity in patients with advanced chronic heart failure (EMSICA Study)

Marc Labrunée et al. PLoS One. .

Abstract

Background: Muscle passive contraction of lower limb by neuromuscular electrostimulation (NMES) is frequently used in chronic heart failure (CHF) patients but no data are available concerning its action on sympathetic activity. However, Transcutaneous Electrical Nerve Stimulation (TENS) is able to improve baroreflex in CHF. The primary aim of the present study was to investigate the acute effect of TENS and NMES compared to Sham stimulation on sympathetic overactivity as assessed by Muscle Sympathetic Nerve Activity (MSNA).

Methods: We performed a serie of two parallel, randomized, double blinded and sham controlled protocols in twenty-two CHF patients in New York Heart Association (NYHA) Class III. Half of them performed stimulation by TENS, and the others tested NMES.

Results: Compare to Sham stimulation, both TENS and NMES are able to reduce MSNA (63.5 ± 3.5 vs 69.7 ± 3.1 bursts / min, p < 0.01 after TENS and 51.6 ± 3.3 vs 56.7 ± 3.3 bursts / min, p < 0, 01 after NMES). No variation of blood pressure, heart rate or respiratory parameters was observed after stimulation.

Conclusion: The results suggest that sensory stimulation of lower limbs by electrical device, either TENS or NMES, could inhibit sympathetic outflow directed to legs in CHF patients. These properties could benefits CHF patients and pave the way for a new non-pharmacological approach of CHF.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Muscle Sympathetic Nerve Activity after stimulation in protocol A.
Figure 2
Figure 2. Muscle Sympathetic Nerve Activity after stimulation in protocol B.
Figure 3
Figure 3. example of Muscle Sympathetic Nerve Activity after sham stimulation and after NeuroMuscular Electrical Stimulation in one patient (protocol B).
See this image and copyright information in PMC

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