Methods of performing vagal-induced asystole

• US 6,656,960 B2
• Filed: 01/17/2002
• Issued: 12/02/2003
• Est. Priority Date: 08/26/1997
• Status: Expired due to Term

• Current Assignee: Emory University
• Original Assignee: Emory University
• Inventors: Puskas, John D.
• Primary Examiner(s): Criares, Theodore J.
• Assistant Examiner(s): JIANG, SHAOJIA A
• Application Number:
  US10/054,669
• Publication Number:
  US 20020183237A1
• Time in Patent Office: 684 Days
• Field of Search: 514/345, 514/741, 514/732, 514/335
• US Class Current: 514/345
• CPC Class Codes: A61K 2300/00 Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• CPC Class Codes: A61K 31/138 Aryloxyalkylamines, e.g. propranolol, tamoxifen, phenoxybenzamine atenolol A61K31/165; pindolol A61K31/404; timolol A61K31/5377
• CPC Class Codes: A61K 31/275 Nitriles; Isonitriles
• CPC Class Codes: A61K 31/277 having a ring, e.g. verapamil
• CPC Class Codes: A61K 31/44 Non condensed pyridines; Hydrogenated derivatives thereof
• CPC Class Codes: A61K 31/445 Non condensed piperidines, e.g. piperocaine
• CPC Class Codes: A61K 31/452 Piperidinium derivatives pancuronium A61K31/58
• CPC Class Codes: A61P 41/00 Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
• CPC Class Codes: A61P 43/00 Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• CPC Class Codes: A61P 9/00 Drugs for disorders of the cardiovascular system

Abstract

A method for indirectly stimulating a vagus nerve of a patient includes the steps of positioning one or more electrodes in the vicinity of the vagus nerve and then actuating the electrode(s) to create an electrical field for stimulating the vagus nerve. Disclosed embodiments include positioning one or more electrodes in the esophagus, trachea, or jugular vein, on the neck of the patient, and combinations thereof.

Claims

1. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting an electrode into the esophagus of said patient; and

actuating said electrode to create an electrical field effective to stimulate said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

2. The method of claim 1,

wherein said step of inserting an electrode into the esophagus of said patient comprises the step of inserting a first electrode into the esophagus of said patient;

wherein said method comprises the further step of inserting a second electrode into the esophagus of said patient in spaced apart relation to said first electrode; and

wherein said step of actuating said electrode to create an electrical field comprises the step of actuating at least one of said first and second electrodes to create an electrical field.

3. The method of claim 2, wherein said step of inserting a second electrode into the esophagus of said patient in spaced apart relation to said first electrode comprises the step of inserting a second electrode into the esophagus of said patient approximately one centimeter from said first electrode.

4. The method of claim 2, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

5. The method of claim 2, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

6. The method of claim 1, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

7. The method of claim 6, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

8. The method of claim 1, wherein said step of actuating said electrode to create an electrical field comprises the step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz.

9. The method of claim 8, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

10. The method of claim 9, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

11. The method of claim 1, wherein said step of actuating said electrode to create an electrical field comprises the step of actuating said electrode to generate electrical impulses having a duration of 0.4 msec.

12. The method of claim 1, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about one to about forty volts.

13. The method of claim 12, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about two to about six volts.

14. The method of claim 1, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

15. The method of claim 1, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

16. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting an electrode into the trachea of said patient; and

actuating said electrode to create an electrical field effective to stimulate said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

17. The method of claim 16,

wherein said step of inserting an electrode into the trachea of said patient comprises the step of inserting a first electrode into the trachea of said patient;

wherein said method comprises the further step of inserting a second electrode into the trachea of said patient in spaced apart relation to said first electrode; and

wherein said step of actuating said electrode to create an electrical field comprises the step of actuating at least one of said first and second electrodes to create an electrical field.

18. The method of claim 17, wherein said step of inserting a second electrode into the trachea of said patient in spaced apart relation to said first electrode comprises the step of inserting a second electrode into the trachea of said patient approximately one centimeter from said first electrode.

19. The method of claim 18, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

20. The method of claim 17, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

21. The method of claim 16, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

22. The method of claim 21, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

23. The method of claim 16, wherein said step of actuating said electrode to create an electrical field comprises the step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz.

24. The method of claim 23, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

25. The method of claim 24, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

26. The method of claim 16, wherein said step of actuating said electrode to create an electrical field comprises the step of actuating said electrode to generate electrical impulses having a duration of 0.4 msec.

27. The method of claim 16, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about one to about forty volts.

28. The method of claim 27, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about two to about six volts.

29. The method of claim 16, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

30. The method of claim 16, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

31. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting an electrode into the jugular vein of said patient; and

actuating said electrode to create an electrical field effective to stimulate said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

32. The method of claim 31, wherein said step of inserting an electrode into the jugular vein of said patient comprises the step of inserting a first electrode into the jugular vein of said patient;

wherein said method comprises the further step of inserting a second electrode into the jugular vein of said patient in spaced apart relation to said first electrode; and

wherein said step of actuating said electrode to create an electrical field comprises the step of actuating at least one of said first and second electrodes to create an electrical field.

33. The method of claim 32, wherein said step of inserting a second electrode into the jugular of said patient in spaced apart relation to said first electrode comprises the step of inserting a second electrode into the jugular vein of said patient approximately one centimeter from said first electrode.

34. The method of claim 32, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

35. The method of claim 32, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

36. The method of claim 31, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

37. The method of claim 36, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

38. The method of claim 31, wherein said step of actuating said electrode to create an electrical field comprises the step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz.

39. The method of claim 38, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

40. The method of claim 39, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

41. The method of claim 31, wherein said step of actuating said electrode to create an electrical field comprises the step of actuating said electrode to generate electrical impulses having a duration of 0.4 msec.

42. The method of claim 31, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about one to about forty volts.

43. The method of claim 42, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about two to about six volts.

44. The method of claim 31, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

45. The method of claim 31, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

46. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

positioning an electrode on the neck of said patient; and

actuating said electrode to create an electrical field effective to stimulate said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

47. The method of claim 46,

wherein said step of positioning an electrode on the neck of said patient comprises the step of positioning a first electrode on the neck of said patient;

wherein said method comprises the further step of positioning a second electrode on the neck of said patient in spaced apart relation to said first electrode; and

wherein said step of actuating said electrode to create an electrical field comprises the step of actuating at least one of said first and second electrodes to create an electrical field.

48. The method of claim 47, wherein said step of positioning a second electrode on the neck of said patient in spaced apart relation to said first electrode comprises the step of positioning a second electrode on the neck of said patient approximately one centimeter from said first electrode.

49. The method of claim 47, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

50. The method of claim 47, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

51. The method of claim 46, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

52. The method of claim 51, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

53. The method of claim 46, wherein said step of actuating said electrode to create an electrical field comprises the step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz.

54. The method of claim 53, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

55. The method of claim 54, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

56. The method of claim 46, wherein said step of actuating said electrode to create an electrical field comprises the step of actuating said electrode to generate electrical impulses having a duration of 0.4 msec.

57. The method of claim 46, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about one to about forty volts.

58. The method of claim 57, wherein said step of actuating said electrode to create an electrical field comprises the step of transmitting to said electrode an electrical impulse having an amplitude of from about two to about six volts.

59. The method of claim 46, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

60. The method of claim 46, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

61. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting a first electrode into the esophagus of said patient;

inserting a second electrode into the trachea of said patient; and

actuating at least one of said electrodes to create an electrical field which stimulates said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

62. The method of claim 61, wherein said step of inserting a second electrode into the trachea of said patient comprises the step of inserting a second electrode into the trachea of said patient to a location approximately one centimeter from said first electrode in said esophagus of said patient.

63. The method of claim 61, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

64. The method of claim 61, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

65. The method of claim 61, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

66. The method of claim 65, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

67. The method of claim 61, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of applying an impulse to at least one of said electrodes at a frequency of between about one Hertz and about five hundred Hertz.

68. The method of claim 67, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

69. The method of claim 68, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

70. The method of claim 61, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating at least one of said electrodes to generate electrical impulses having a duration of 0.4 msec.

71. The method of claim 61, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about one to about forty volts.

72. The method of claim 71, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about two to about six volts.

73. the method of claim 61, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

74. The method of claim 61, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

75. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting a first electrode into the esophagus of said patient;

inserting a second electrode into a jugular vein of said patient; and

actuating at least one of said electrodes to create an electrical field which stimulates said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

76. The method of claim 75, wherein said step of inserting a second electrode into a jugular vein of said patient comprises the step of inserting a second electrode into a jugular vein of said patient to a location approximately one centimeter from said first electrode in said esophagus of said patient.

77. The method of claim 75, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

78. The method of claim 75, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

79. The method of claim 75, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

80. The method of claim 79, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

81. The method of claim 75, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of applying an impulse to at least one of said electrodes at a frequency of between about one Hertz and about five hundred Hertz.

82. The method of claim 81, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

83. The method of claim 82, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

84. The method of claim 75, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating at least one of said electrodes to generate electrical impulses having a duration of 0.4 msec.

85. The method of claim 75, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about one to about forty volts.

86. The method of claim 85, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about two to about six volts.

87. The method of claim 75, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

88. The method of claim 75, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

89. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting a first electrode into the esophagus of said patient;

placing a second electrode on the neck of said patient; and

actuating at least one of said electrodes to create an electrical field which stimulates said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

90. The method of claim 89, wherein said step of positioning a second electrode on the neck of said patient comprises the step of positioning a second electrode on the neck of said patient at a location approximately one centimeter from said first electrode in said esophagus of said patient.

91. The method of claim 89, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

92. The method of claim 89, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

93. The method of claim 89, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

94. The method of claim 93, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

95. The method of claim 89, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of applying an impulse to at least one of said electrodes at a frequency of between about one Hertz and about five hundred Hertz.

96. The method of claim 95, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

97. The method of claim 96, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

98. The method of claim 89, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating at least one of said electrodes to generate electrical impulses having a duration of 0.4 msec.

99. The method of claim 89, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about one to about forty volts.

100. The method of claim 99, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about two to about six volts.

101. The method of claim 89, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

102. The method of claim 89, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

103. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting a first electrode into the trachea of said patient;

inserting a second electrode into a jugular vein of said patient; and

actuating at least one of said electrodes to create an electrical field which stimulates said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

104. The method of claim 103, wherein said step of inserting a second electrode into a jugular vein of said patient comprises the step of inserting a second electrode into a jugular vein of said patient to a location approximately one centimeter from said first electrode in said trachea of said patient.

105. The method of claim 103, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

106. The method of claim 103, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

107. The method of claim 103, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

108. The method of claim 107, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

109. The method of claim 103, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of applying an impulse to at least one of said electrodes at a frequency of between about one Hertz and about five hundred Hertz.

110. The method of claim 109, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

111. The method of claim 110, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

112. The method of claim 103, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating at least one of said electrodes to generate electrical impulses having a duration of 0.4 msec.

113. The method of claim 103, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about one to about forty volts.

114. The method of claim 113, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about two to about six volts.

115. The method of claim 103, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

116. The method of claim 103, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

117. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting a first electrode into the trachea of said patient;

placing a second electrode on the neck of said patient; and

actuating at least one of said electrodes to create an electrical field which stimulates said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

118. The method of claim 117, wherein said step of positioning a second electrode on the neck of said patient comprises the step of positioning a second electrode on the neck of said patient at a location approximately one centimeter from said first electrode in said trachea of said patient.

119. The method of claim 117, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

120. The method of claim 117, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

121. The method of claim 117, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

122. The method of claim 121, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

123. The method of claim 117, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of applying an impulse to at least one of said electrodes at a frequency of between about one Hertz and about five hundred Hertz.

124. The method of claim 123, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

125. The method of claim 124, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

126. The method of claim 117, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating at least one of said electrodes to generate electrical impulses having a duration of 0.4 msec.

127. The method of claim 117, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about one to about forty volts.

128. The method of claim 126, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about two to about six volts.

129. The method of claim 117, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

130. The method of claim 117, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.

131. A method of performing vagal-induced asystole in a patient comprising the steps of:

administering an amount of a pharmaceutical composition effective to produce cardiac asystole upon stimulation of one or both vagus nerves;

inserting a first electrode into a jugular vein of said patient;

placing a second electrode on the neck of said patient; and

actuating at least one of said electrodes to create an electrical field which stimulates said vagus nerve;

wherein the pharmaceutical composition comprises an acetylcholinesterase inhibitor, a β

-adrenergic receptor blocker, and a calcium channel blocker.

132. The method of claim 131, wherein said step of positioning a second electrode on the neck of said patient comprises the step of positioning a second electrode on the neck of said patient at a location approximately one centimeter from said first electrode in said jugular vein of said patient.

133. The method of claim 131, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating both of said first and second electrodes to create an electrical field.

134. The method of claim 131, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating one or both of said electrodes in one of a unipolar or a bipolar mode.

135. The method of claim 131, wherein said vagus nerve is stimulated for a period of between about five and about ninety seconds.

136. The method of claim 135, wherein said vagus nerve is stimulated for a period of between about five and about fifteen seconds.

137. The method of claim 131, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of applying an impulse to at least one of said electrodes at a frequency of between about one Hertz and about five hundred Hertz.

138. The method of claim 137, wherein said step of applying an impulse at a frequency of between about one Hertz and about five hundred Hertz comprises the step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz.

139. The method of claim 138, wherein said step of applying an impulse at a frequency of between about twenty Hertz and about eighty Hertz comprises the step of applying an impulse at a frequency of about forty Hertz.

140. The method of claim 131, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of actuating at least one of said electrodes to generate electrical impulses having a duration of 0.4 msec.

141. The method of claim 131, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about one to about forty volts.

142. The method of claim 141, wherein said step of actuating at least one of said electrodes to create an electrical field comprises the step of transmitting to at least one of said electrodes an electrical impulse having an amplitude of from about two to about six volts.

143. The method of claim 131, wherein said vagus nerve is stimulated during a surgical procedure selected from the group consisting of:

coronary artery bypass graft surgery, off-pump coronary artery bypass graft surgery, coronary artery bypass surgery performed on cardiopulmonary bypass, partially or totally endoscopic coronary artery bypass graft surgery, percutaneous or surgical transmyocardial laser revascularization procedure, or a surgical procedure performed upon a heart, heart valves, myocardium, coronary vascular structure, peripheral vascular structure, an electrophysiological procedure, a neurosurgical procedure, or a percutaneous transcatheter coronary procedure.

144. The method of claim 131, wherein said step of actuating said electrode to create an electrical field effective to stimulate said vagus nerve comprises the step of creating an electrical field effective to stimulate said vagus nerve to achieve asystole.