VAGUS NERVE STIMULATION

The cardiovascular centres in the brain alter the intrinsic discharge rate of the SA node via the ANS and the hormone adrenaline. The sympathetic nerves increase and the parasympathetic nerves decrease the heart rate. At rest, there is tonic activity in both sympathetic and parasympathetic nerves but the latter are more active in humans, reducing the rate from its intrinsic value of about 100- 70 beats min-1. Since the parasympathetic fibers project to the heart in the vagus nerve, their normal activity is often referref as vagal tone. Intense parasympathetic activity can actually stop the pacemaker of the heart for a brief period.
- About 75% of all parasympathetic nerve fibers are in the Vagus nerves (X), and passing through the entire thoracic and abdominal regions of the body. -Vagal nerves are distributed mainly in the atria, and only a little in the ventricles, which is the reason for the PRIMARY EFFECT of vagal nerve stimulation of decreased heart rate (heart contraction decrease is only secondary because it is the work of the ventricles). - Strong stimulation of the parasympathetic nerve fibers in the Vagus nerves to the heart can stop the heartbeat for a few seconds

-Bradycardia- low heart rate - but then the heart usually escapes (called ventricular escape) and
beats at a rate of 20 40 beats per minute as long as the parasympathetic stimulation continues. -Causes of Ventricular or Vagal Escape - Ventricular escape happens because at some point in the Purkinje fibers, specifically in the ventricular septal portion of the AV bundle, develops a rhythm of its own and causes ventricular contraction at a arate of 15 40 beats per minutefrom Guyton a.) Exhaustion of Acetylcholine b.) Increased destruction of acetylcholine by choline esterase c.)Heart becomes refractory to the action of acetylcholine
d.) Bainbridge reflex, also called the atrial reflex, is an increase in heart rate due to an increase in central venous pressure.[1] Increased blood volume is detected by stretch receptors located in both atria at the venoatrial junctions.e.)Sinoaortic reflex

f.) Idioventricular rhythm the rate is 30-45 bpm. The QRS complexes are wide (> 0.12 sec, often > 0.16 sec) because the ventricular signal is transmitted by cell-to-cell conduction between cardiomyocytes and not by the conduction system. - Additionally, strong vagal stimulation CAN decrease the strength of heart muscle contraction by 20 30 percent. -All in all, a great decrease in heart rate and a slight decrease in heart contraction can decrease ventricular pumping by 50% or more. - Acetylcholine has two major effects to the heart. First, it decreases the rate of rhythm of the SA Node. Second, it decreases the excitability of the AV Node which results in a slower transmission of cardiac impulse into the ventricles. - Acetylcholine also causes hyperpolarization of the heart by greatly increasing the permeability of the potassium ions, which allows for rapid leakage of potassium out of the conductive fibers. - Normally, ventricles stop beating for 5 20 seconds