2-Year Follow-Up of Baroreflex Activation Therapy for Severe Heart Failure With Reduced Ejection Fraction

Baroreflex activation therapy (BAT) is a novel treatment for heart failure with reduced ejection fraction (HFrEF) in patients who remain symptomatic despite optimal medical therapy (OMT) and who are unsuitable for cardiac resynchronization therapy (CRT). BAT modulates the autonomic nervous system by electrically stimulating carotid baroreceptors, thus potentially improving heart function and symptoms.

Two male HFrEF patients with nonischemic cardiomyopathy, symptomatic (NYHA functional class III) despite OMT, underwent successful BAT implantation. Patient 1, a 41-year-old man with a left ventricular ejection fraction (LVEF) of 34%, and patient 2, a 49-year-old man with an LVEF of 21%, showed significant improvements at 2-year follow-up, including increased LVEF, reduced N-terminal pro-B-type natriuretic peptide, better exercise capacity, and symptomatic relief (NYHA functional class II). Both patients avoided hospital readmissions and had no complications.

This case series demonstrates BAT's potential for improving clinical outcomes in HFrEF patients ineligible for CRT. Further research is necessary to confirm these findings in larger groups.