Rutkovskis, E.; Ravagli, E.; Lancashire, H.; Shah Idil, A.; Thompson, N.; Perkins, J.; Challita, R.; Hadaya, J.; Vivekananda, U.; Ajijola, O.; Shivkumar, K.; Miserocchi, A.; McEvoy, A.; Holder, D.; Aristovich, K.

Vagus nerve stimulation (VNS) is an established clinical therapy for drug-resistant epilepsy and shows potential for treating other conditions, including depression, rheumatoid arthritis, diabetes, and heart failure. However, stimulation often produces unwanted side effects such as hoarseness, coughing, and paraesthesia. In some cases, these effects limit the delivery of therapeutic stimulation levels and hinder the development of new neuromodulation therapies. Selective VNS (sVNS) offers a strategy to reduce off-target organ activation. Methods. This work presents an NFC-controlled, wirelessly powered, battery-free, temporary implantable multichannel stimulation device, made with off-the-shelf components, enabling selective stimulation of specific regions of the VN. The encapsulated device is suitable for short-term implantation in animals. Main result. The sVNS device was investigated in a porcine (n = 4) trial and an n = 1 pilot human experiment. Selective bradycardia of 23.28 {+/-} 12.91% was achieved in pigs and 7.5% in the human participant. In humans, a clear separation of cardiac efferent and afferent stimulation was observed, with additional selectivity in laryngeal activity. Physiological effects of laryngeal and cardiac fibre separation were measured to be 231{degrees}. Significance. Geometrically selective stimulation of VN fascicles has the potential to improve clinical outcomes, enhance therapeutic efficacy, and reduce stimulation-related side effects. This strategy may enhance neuromodulation approaches for the treatment of heart failure using VNS.