The goal of this multicenter, double-blind, randomized controlled trial is to evaluate the efficacy and safety of low-intensity focused ultrasound (LIFU) stellate ganglion modulation for improving autonomic function and sleep quality in perioperative cardiovascular disease patients. The main questions it aims to answer are: 1. Does LIFU improve heart rate variability and sleep characteristics from baseline at 3-7 days post-surgery compared to sham ultrasound? 2. Does LIFU improve serological markers, vital signs, Pittsburgh Sleep Quality Index (PSQI), and reduce \>30-second perioperative arrhythmias? 3. What is the safety profile of LIFU in this population? 200 eligible patients will be randomized 1:1 to receive either active LIFU (2.0W, 1MHz, 50% duty cycle, 30min daily for 3-7 days) plus standard care, or identical sham ultrasound plus standard care. A four-party double-blind design (subjects, operators, assessors, analysts) will be implemented. The study will run from May 1, 2026 to April 1, 2027 at 6 centers in China. Participants will: 1. Complete pre-surgery screening and baseline assessments (PSQI, 12h ECG/sleep monitoring, residual blood sample collection) 2. Receive daily assigned ultrasound intervention for 3-7 consecutive days post-surgery 3. Undergo 72h continuous ECG monitoring post-surgery, and repeat assessments at 3-7 days 4. Have all adverse events and arrhythmias recorded throughout the study 5. May withdraw voluntarily at any time without affecting routine medical care
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
200
The experimental group receives active low-intensity focused ultrasound (LIFU) treatment: the ultrasound probe is placed on the skin surface corresponding to the left stellate ganglion and fixed with a mechanical arm, with parameters set as power 2.0W, frequency 1MHz, duty cycle 50%, 30 minutes per session, once daily for 3-7 consecutive days. All enrolled subjects receive standard perioperative cardiovascular care simultaneously throughout the study period.
The control group receives sham low-intensity focused ultrasound intervention: the ultrasound probe is placed on the skin surface corresponding to the left stellate ganglion and fixed with a mechanical arm, with the same instrument appearance, operation process, parameter setting display (power 2.0W, frequency 1MHz, duty cycle 50%), duration (30 minutes per session, once daily for 3-7 consecutive days) and subject experience as the experimental group, but no actual ultrasound energy is output. All enrolled subjects receive standard perioperative cardiovascular care simultaneously throughout the study period.
Huangshi Central Hospital
Huangshi, Hubei, China
NOT_YET_RECRUITINGJingzhou Central Hospital
Jingzhou, Hubei, China
NOT_YET_RECRUITINGRenmin Hospital of Wuhan University
Wuhan, Hubei, China
RECRUITINGWuhan Central Hospital
Wuhan, Hubei, China
NOT_YET_RECRUITINGWuhan Third Hospital
Wuhan, Hubei, China
NOT_YET_RECRUITINGXiangyang Central Hospital
Xiangyang, Hubei, China
NOT_YET_RECRUITINGYichang Central People's Hospital
Yichang, Hubei, China
NOT_YET_RECRUITINGSDNN
Standard deviation of all normal-to-normal intervals measured by wearable Holter monitor; Unit: ms; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Total sleep duration
Total sleep time measured by wearable sleep monitor; Unit: hours; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
SDANN
Standard deviation of the averages of NN intervals in all 5-minute segments; Unit: ms; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
SDNN Index
Mean of the standard deviations of all NN intervals for all 5-minute segments; Unit: ms; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
RMSSD
Root mean square of successive differences between normal heartbeats; Unit: ms; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
pNN50
Percentage of successive NN intervals that differ by more than 50 ms; Unit: %; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
LF power
Low frequency power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
HF power
High frequency power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
TP
Total power of heart rate variability; Unit: ms²; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
LF/HF ratio
Ratio of low frequency to high frequency power; Unit: ratio; Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Wakefulness percentage
Percentage of time awake during sleep period; Unit: %; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Insomnia percentage
Percentage of time with insomnia symptoms during sleep period; Unit: %; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
REM sleep percentage
Percentage of rapid eye movement sleep during total sleep time; Unit: %; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
N1 sleep stage percentage
Percentage of N1 sleep stage during total sleep time; Unit: %; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
N2 and N3 sleep stages percentage
Combined percentage of N2 and N3 sleep stages during total sleep time; Unit: %; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Sleep efficiency
Ratio of total sleep time to time in bed; Unit: %; Measurement device: Wearable sleep monitor.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
IL-1β level
Serum IL-1β concentration; Unit: pg/mL.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Norepinephrine (NE) level
Serum norepinephrine concentration; Unit: pg/mL.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Brain-derived neurotrophic factor (BDNF) level
Serum brain-derived neurotrophic factor concentration; Unit: pg/mL.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Pittsburgh Sleep Quality Index (PSQI) score
Subjective sleep quality assessed using the Pittsburgh Sleep Quality Index questionnaire; Unit: Score on a 0-21 scale, where higher scores indicate worse sleep quality; Method of Measurement: Self-administered questionnaire.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Number of atrial arrhythmias
Measurement: count of atrial arrhythmia episodes. Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Duration of atrial arrhythmias
Measurement: Duration of atrial arrhythmia episodes. Measurement device: wearable Holter monitors.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
TNF-α level
Serum TNF-α concentration; Unit: pg/mL.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
Neuropeptide Y (NPY) level
Serum neuropeptide Y concentration; Unit: pg/mL.
Time frame: Pre-operative 24 hours and Post-operative 72 hours
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Melatonin level
Serum melatonin concentration; Unit: pg/mL.
Time frame: Pre-operative 24 hours and Post-operative 72 hours