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Study summary · Sleep, circadian rhythm & stress

Does low-level transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) reduce postural tachycardia in patients with Postural Tachycardia Syndrome (POTS) over a 2-month period?

JACC Clin Electrophysiol · 2023 · PMID 37999672 · DOI 10.1016/j.jacep.2023.10.015

Plain-English summary written and published by Magellan Longevity · medical review by Gabriel Radu, DO (physiatrist, NPI 1376861765). We summarize what the paper reported — we did not run this study.

The takeaway

Daily transcutaneous vagus nerve stimulation reduced postural tachycardia and improved related biomarkers in patients with POTS over two months.

The question

Does low-level transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) reduce postural tachycardia in patients with Postural Tachycardia Syndrome (POTS) over a 2-month period?

What they tested

The authors hypothesized that tVNS would be beneficial in patients with POTS, based on preliminary animal studies and the known antiarrhythmic and anti-inflammatory effects of auricular vagus stimulation.

How they did it

This was a sham-controlled, double-blind, randomized clinical trial. Participants with POTS received either active tVNS (20 Hz, 1 mA below discomfort threshold at the tragus) or sham stimulation (ear lobe) for 1 hour daily over 2 months. Postural tachycardia, heart rate variability, serum cytokines, and antiautonomic autoantibodies were measured at baseline and after 2 months.

What they found

At 2 months, the active tVNS group showed significantly less postural tachycardia (mean postural increase in heart rate 17.6 ± 9.9 beats/min) compared to the sham group (31.7 ± 14.4 beats/min; P = 0.01). Antiadrenergic autoantibodies and inflammatory cytokines were lower, and heart rate variability was better in the active arm. No device-related side effects were observed.

Mean Postural Increase in Heart Rate at 2 Months
Values shown: Heart Rate Increase (beats/min)
Active tVNS17.6
Sham Stimulation31.7

The active tVNS group experienced a significantly smaller increase in heart rate upon standing compared to the sham group after 2 months.

What it means

The study concludes that noninvasive neuromodulation with tVNS can treat POTS, likely by reducing antiautonomic autoantibodies and inflammatory cytokines, and improving autonomic tone.

Limitations

The abstract states that further studies are warranted, implying that this study, while supportive, is not definitive.

“stimulation of the auricular branch of the vagus nerve is antiarrhythmic and anti-inflammatory”— from the published abstract, JACC Clin Electrophysiol 2023

The paper at a glance

Magellan’s evidence labelauricular vagus stimulation (our label for this citation — see PubMed for the paper’s own title and authors)
JournalJACC Clin Electrophysiol
Year2023
PMID37999672 ↗
DOI10.1016/j.jacep.2023.10.015 ↗
TopicSleep, circadian rhythm & stress

Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗

Where Magellan uses this paper

This citation sits behind the evidence grade on the pages below. Grades are set from the research and are independent of affiliate commissions.

Vagus Nerve Stimulator (tVNS)

Improves autonomic balance, anti-inflammatory. Research relevant to this mechanism is indexed on PubMed and linked below; it describes the mechanism rather than this specific product.

Molecules & mechanisms in this paper

Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.

Heart rate variability

Cite this page

These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.

APA
Magellan Longevity. (2026). Does low-level transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) reduce postural tachycardia in patients with Postural Tachycardia Syndrome (POTS) over a 2-month period? [Plain-English summary of JACC Clin Electrophysiol 2023, PMID 37999672, DOI 10.1016/j.jacep.2023.10.015]. Magellan Longevity. https://magellanlongevity.com/study/s164.html
BibTeX
@misc{magellan_s164, title = {Does low-level transcutaneous stimulation of the auricular branch of the vagus nerve (tVNS) reduce postural tachycardia in patients with Postural Tachycardia Syndrome (POTS) over a 2-month period?}, author = {{Magellan Longevity}}, year = {2026}, howpublished = {\url{https://magellanlongevity.com/study/s164.html}}, note = {Plain-English summary of PubMed PMID 37999672; DOI 10.1016/j.jacep.2023.10.015; JACC Clin Electrophysiol 2023. Reviewed by Gabriel Radu, DO}, urldate = {2026-08-11} }
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How this summary was made. Every section above restates what the published abstract of PMID 37999672 reports — the question, the design, the numbers, the authors’ own conclusion and their stated limitations. We do not add claims the paper did not make, and we keep negative and no-effect findings in. Magellan’s evidence grades are set from research like this and never from affiliate commissions.

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Educational information, not medical advice. This is a plain-English summary of published research; it is not a treatment recommendation and nothing here is intended to diagnose, treat, cure, or prevent any disease. Individual studies can be wrong, and a single paper rarely settles a question. Talk to your physician before acting on any research, especially if you are pregnant, nursing, or taking medication.