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Wiener Medizinische Wochenschrift

, Volume 164, Issue 23–24, pp 508–514 | Cite as

Electrical carotid baroreceptor stimulation

  • Jürg SchmidliEmail author
  • Regula S. von Allmen
  • Markus G. Mohaupt
main topic

Summary

The Barostim neoTM system is a novel implantable device that activates the carotid baroreflex. It decreases the sympathetic activity and inhibits the renin system, which results in reduced blood pressure and heart rate. In patients with resistant hypertension, electrically activation of the baroreflex leads to an average decrease in systolic blood pressure of 38, 36, 40 and 53 mmHg at 1, 2, 3 and 4 years, respectively. Additionally, cardiac remodelling with reduced left ventricular mass and posterior wall thickness has been observed in long-term studies. In a limited number of patients with heart failure, baroreflex activation therapy leads to a decrease in muscle sympathetic nerve activity and to improved quality of life and functional capacities. The implantation procedure is safe and associated with risks comparable with those of other active implantable devices. Barostim neo is currently available in several European countries.

Keywords

Baroreflex activation therapy Drug-resistant hypertension Heart failure Barostim neoTM 

Interventionelle kardiovaskuläre Therapie bei Bluthochdruck

Zusammenfassung

Das Barostim neoTM System ist ein neues Gerät, welches elektrisch den Baroreflex-Mechanismus aktiviert (Karotisstimulator). Durch die Reduktion des Sympathikotonus und das Dämpfen das Renin-Systems bewirkt es ein Absenken von Blutdruck und Herzfrequenz. Bei Patienten mit therapierefraktärer Hypertonie führte die elektrische Aktivierung des Baroreflexes im Langzeit-Verlauf zu einer dauerhaften durchschnittlichen Senkung des systolischen Blutdrucks um 38, 36, 40 und 53 mmHg nach 1, 2, 3 und 4 Jahren. Ausserdem konnte bei diesen Patienten eine Reduktion der links-ventrikulären Masse und der posterioren Wanddicke beobachtet werden. Bei einigen Patienten mit Herzinsuffizienz konnte eine Reduktion der sympathischen Muskelaktivität bewirkt werden und eine wesentliche Verbesserung der Lebensqualität und der körperlichen Leistung beobachtet werden. Die Implantation des Gerätes gilt als sicher; die Risiken sind vergleichbar mit anderen implantierbaren Stimulatoren. Barostim neo ist nun in mehreren europäischen Ländern erhältlich.

Schlüsselwörter

Elektrische Baroreflex Aktivierung Therapierefraktäre Hypertonie Herzinsuffizienz Barostim neoTM 

Notes

Conflict of interest

All authors declare no conflict of interest.

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Jürg Schmidli
    • 1
    Email author
  • Regula S. von Allmen
    • 1
  • Markus G. Mohaupt
    • 2
  1. 1.Dept of Cardiovascular SurgeryBern University HospitalBernSwitzerland
  2. 2.Dept of Nephrology, Hypertension and Clinical PharmacologyBern University HospitalBernSwitzerland

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