Abstract
Baroreflex activation therapy (BAT) produces a central inhibition of cardiac sympathetic outflow and, concomitantly, an increased cardiac vagal activity via a physiological reflex pathway. In a pilot study in 11 patients with NYHA class III heart failure (HF), BAT produced a persistent significant reduction of muscle sympathetic nerve activity over a 21-month follow-up and a dramatic decrease in the number and length of hospitalizations. In a multinational, prospective, randomized, parallel-controlled, clinical trial in 146 NYHA functional class III HF, BAT produced a significant N-terminal pro-brain natriuretic peptide reduction (p = 0.02). This was associated with a trend toward few in hospital days for HF. BAT might become a powerful tool to manipulate autonomic alterations of HF at their origin and thus profoundly affect advanced HF patient prognosis.
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Edoardo Gronda has received grants from CVRx and is presently a consultant to CVRx outside of the submitted work.
Emilio Vanoli is presently a consultant to CVRx outside of the submitted work.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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This article is part of the Topical Collection on Pathophysiology: Neuroendocrine, Vascular, and Metabolic Factors
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Gronda, E., Vanoli, E. Autonomic Modulation With Baroreflex Activation Therapy in Heart Failure. Curr Heart Fail Rep 13, 273–280 (2016). https://doi.org/10.1007/s11897-016-0307-7
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DOI: https://doi.org/10.1007/s11897-016-0307-7