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Vagus nerve stimulation (VNS) has been reported to exert cardioprotective effects, but its efficacy in preconditioning against I\/R injury requires further investigation. We evaluated the cardioprotective effects of VNS preconditioning in a rat model of acute myocardial infarction with induced I\/R injury. Sixty rats were randomized into Pre\u2010VNS, Control and Sham groups. The Pre\u2010VNS group received 1 week of low\u2010level cervical VNS before induction of I\/R injury; stimulation was deactivated 30 min before ischaemia. Survival, echocardiographic function, reperfusion arrhythmias, arrhythmia inducibility, infarct size, apoptosis and inflammatory cytokines were assessed. Survival did not differ significantly between Pre\u2010VNS and Control groups (75.0%\u00a0vs. 65.0%,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.497). However, Pre\u2010VNS animals exhibited preserved cardiac function, with higher ejection fraction and fractional shortening (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.001). VNS preconditioning reduced the incidence of reperfusion arrhythmia during left anterior descending coronary artery ligature release (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.006) and decreased the arrhythmia index on programmed stimulation (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.003). Infarct size and cardiomyocyte apoptosis were significantly attenuated (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.001), accompanied by markedly lower serum interleukin\u20101\u03b2, interleukin\u20106 and tumour necrosis factor\u2010alpha levels (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.001). VNS preconditioning effectively mitigates I\/R injury by improving cardiac function, reducing infarct size and arrhythmias, and attenuating inflammatory and apoptotic responses.\n                  <\/jats:p>","DOI":"10.1113\/ep092950","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T06:21:06Z","timestamp":1762496466000},"page":"714-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cardioprotection via vagus nerve stimulation preconditioning: Reducing ischaemia\u2013reperfusion injury and arrhythmic risk"],"prefix":"10.1113","volume":"111","author":[{"given":"Feng","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Diseases, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danfeng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihui","family":"Zheng","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yao","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhua","family":"Zang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine Shanghai Jiaotong University  Shanghai 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