title: Baroreflex Activation Therapy in Heart Failure With Reduced Ejection Fraction: Available Data and Future Perspective.
abstract: Progression of heart failure with reduced ejection fraction (HFrEF) is promoted by sympathovagal imbalance. Baroreflex activation therapy, i.e., electrical stimulation of baroreceptors at the carotid sinus, can restore sympathovagal balance. Large animal studies of baroreflex activation therapy revealed improvements in cardiac function, susceptibility to ventricular arrhythmias, and a survival benefit as compared to untreated controls. Recently, the first randomized and controlled trial of optimal medical and device therapy alone or plus baroreflex activation therapy in patients suffering from HFrEF was published. It demonstrated a reasonable safety profile in this severely ill patient population. Moreover, the study found significant improvements in New York Heart Association class, quality of life, 6-min walk distance, and NT-proBNP levels. This review provides an overview on baroreflex activation therapy for the treatment of HFrEF-from the concept and preclinical findings to most recent clinical data and upcoming trials.
authors.affiliation: Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. marcel.halbach@uk-koeln.de.
authors.forename: Marcel
authors.initials: M
authors.lastname: Halbach
authors.affiliation: Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Fritz
authors.affiliation: Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne, Germany.
authors.forename: Navid
authors.initials: N
authors.lastname: Madershahian
authors.affiliation: Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Pfister
authors.affiliation: Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
authors.forename: Hannes
authors.initials: H
authors.lastname: Reuter
mesh_terms: D017704:Baroreflex / Q000502:physiology*; D002346:Carotid Sinus / Q000502:physiology; D004599:Electric Stimulation Therapy; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D011311:Pressoreceptors / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology
keywords: Baroreceptors; Baroreflex activation therapy; Carotid sinus stimulation; Heart failure