Pacemaker-Based Cardiac Neuromodulation Therapy in Patients With Hypertension: A Pilot Study

Area of Science:

• Cardiology
• Hypertension Management
• Medical Devices

Background:

• Previous unblinded studies indicated cardiac neuromodulation therapy (CNT) reduces systolic blood pressure (SBP) in hypertensive patients.
• The efficacy of CNT in lowering SBP was evaluated in a double-blind, randomized pilot study.

Purpose of the Study:

• To assess the effect of CNT on 24-hour ambulatory SBP in hypertensive patients with an indication for a dual-chamber pacemaker.
• To determine the safety and efficacy of CNT as a treatment for hypertension.

Main Methods:

• A double-blind, randomized pilot study involving 47 hypertensive patients (mean age 74.0 years) who received a Moderato pacemaker.
• Patients were randomized (1:1) to receive active CNT or inactive CNT (control) for 6 months.
• The primary endpoint was the change in 24-hour ambulatory SBP from baseline to 6 months.

Main Results:

• Cardiac neuromodulation therapy resulted in a significant reduction in 24-hour SBP by 8.1 mm Hg compared to the control group (P=0.012).
• The treatment group experienced an average SBP reduction of 11.1 mm Hg, while the control group showed a 3.1 mm Hg reduction.
• No adverse events related to the device or CNT were reported.

Conclusions:

• Cardiac neuromodulation therapy (CNT) effectively reduces 24-hour SBP in hypertensive patients indicated for a pacemaker.
• CNT presents a promising therapeutic option for managing hypertension, particularly in patients with isolated systolic hypertension.
• The study demonstrated the safety of CNT in this patient population.