Striking improvement in a case of reduced ejection fraction heart failure with baroreflex activation therapy

A patient experiencing chronic New York Heart Association (NYHA) Class III heart failure with reduced left ventricular ejection fraction and signs of right ventricular dysfunction is treated with baroreflex activation therapy (BAT). Despite optimal medical therapy, the patient had repeatedly decompensated and was approaching a refractory terminal stage. BAT chronically reduced muscle sympathetic nerve activity and dramatically improved clinical presentation of the patient to NYHA Class I through 12 months of therapy. BAT may hold promise for patients with advanced heart failure and reduced ejection fraction who have exhausted conventional therapy options. <Learning objective: Activation of the baroreflex via stimulation of the carotid sinus acutely improves hemodynamics and chronically improves the clinical course of a patient with heart failure and reduced ejection fraction. The patient transitions from near end-stage New York Heart Association Class III to Class I at 12 months of therapy. The baroreflex pathway may be a viable option for treatment of heart failure patients.>.