Nonpharmacologic Treatment for Heart Failure: A Review of Implantable Carotid Baroreceptor Stimulators As a
Boniface Malangu1, Gregg M Lanier2, William H Frishman2
1From the Department of Internal Medicine, Rutgers-New Jersey Medical School, Newark, NJ.
Insights
Baroreceptor activation therapy is an investigational device-based treatment for heart failure (HF). This novel therapy shows promising results and a good safety profile for managing HF patients.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Heart failure (HF) presents high morbidity and mortality despite pharmacologic advances.
- Device-based therapies are increasingly researched for HF treatment.
- Baroreceptor activation therapy (BAT) is a novel approach following cardiac resynchronization therapy success.
Purpose of the Study:
- To review the current technology and literature on baroreceptor activation therapy (BAT) for heart failure (HF).
- To focus on BAT's application in HF patients with various comorbidities.
Main Methods:
- Review of existing clinical investigations and published literature on BAT for HF.
- Analysis of the Barostim neo device's mechanism of action: electrical activation of the baroreceptor reflex.
- Assessment of safety and efficacy data from trials in diverse HF patient populations.
Main Results:
- Preliminary clinical studies show promising results for BAT in HF.
- The Barostim neo device aims to correct autonomic imbalance in HF patients.
- BAT has demonstrated benefits with a favorable safety profile in ongoing trials.
Conclusions:
- Baroreceptor activation therapy is an emerging, investigational device-based treatment for heart failure.
- The therapy holds potential for patients with mild to severe HF, including those with comorbidities.
- Further research and trials are evaluating BAT's role in comprehensive HF management.
Abstract:
There has been significant interest in research for the development of device-based therapy as a treatment option of heart failure (HF), whether it is with reduced or preserved ejection fraction. This is due to the high morbidity and mortality rate in patients with HF despite recent advances in pharmacologic treatment. Following the success of cardiac resynchronization therapy, baroreceptor activation therapy has emerged as another novel device-based treatment for HF. The Barostim neo was developed by CVRx Minneapolis, MN for the treatment of mild to severe HF. The device works by electrically activating the baroreceptor reflex with the goal to restore the maladaptive autonomic imbalance that is seen in patients with HF. Preliminary clinical investigations have given promising results with an encouraging safety profile. Baroreceptor activation therapy as a treatment option is still investigational at this time; however, several trials in different patient populations have already shown benefit with a very good safety profile. In this review, we will summarize the current state of technology and the available literature of the use of baroreceptor activation therapy in patients with different comorbidities, with a focus on this device-based therapy in patients with HF.
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