Autonomic Regulation Therapy via Left or Right Cervical Vagus Nerve Stimulation in Patients With Chronic Heart Failure: Results of the ANTHEM-HF Trial

Premchand, Rajendra Kumar; Sharma, Kamal; Mittal, Sanjay; Monteiro, Rufino; Dixit, Satyajit; Libbus, Imad; DiCarlo, Lorenzo A.; Ardell, Jeffrey L.; Rector, Thomas S.; Amurthur, Badri; KenKnight, Bruce H.; Anand, Inder S.

doi:10.1016/j.cardfail.2014.08.009

Cited by 314 publications

(277 citation statements)

References 40 publications

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“…The INOVATE-HF trial (with 436 patients implanted with VNS stimulators) designed as an outcome trial failed to show benefit of VNS in the hard endpoints of death and heart failure events whilst there again appeared to be some subjective symptomatic improvement. A smaller ANTHEM-HF trial (Premchand et al 2014) (with 60 patients implanted with VNS stimulators) showed some positive results similar to the initial pilot study. These clinical results have significantly reduced the momentum, which was built in the clinical translation of VNS in patients with heart failure and hence would not help in addressing the question whether VNS has a favourable effect on ventricular arrhythmia events.…”

Section: Indirect Antiarrhythmic and Non-arrhythmic Beneficial Effsupporting

confidence: 52%

Neuro-cardiac interaction in malignant ventricular arrhythmia and sudden cardiac death

2016

Autonomic Neuroscience

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Sudden cardiac death as a result of lethal ventricular arrhythmias is a major cause of death in cardiac diseases such as heart failure and prior myocardial infarct. Activity of the autonomic nervous system is often abnormal where sympathetic activity is upregulated and vagal activity reduced in these conditions. The abnormal autonomic state has been shown to be a strong prognostic marker of increased mortality and propensity to lethal arrhythmias, for which there is no effective prevention. Research effort over the years has established good evidence for a causal link between autonomic disturbance and ventricular arrhythmias. However, the detailed electrophysiological mechanisms by which ventricular fibrillation occurs are still not clear and molecular processes which are modulated by autonomic nerve influences that either predispose the heart to or protect it from these arrhythmias are not fully understood. This review presents data from studies investigating the link between activity of the autonomic nervous system and ventricular arrhythmias, from seminal findings in classical studies to ongoing investigations, in the quest for a better understanding of the arrhythmogenic mechanisms underlying neurocardiac interactions with a view to the development of effective preventative and therapeutic strategies which are very much needed.

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Section: Indirect Antiarrhythmic and Non-arrhythmic Beneficial Effsupporting

confidence: 52%

Neuro-cardiac interaction in malignant ventricular arrhythmia and sudden cardiac death

2016

Autonomic Neuroscience

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“…Preliminary results using VNS showed promise and stimulation of the right cervical vagus nerve with pulses synchronised to the cardiac cycle improved NYHA class, quality of life scores and left ventricular end-systolic volume (Schwartz et al, 2008). Larger studies subsequently showed VNS was associated with a significant improvement in cardiac function, quality of life scores and exercise performance (De Ferrari et al, 2011;Premchand et al, 2014).…”

Section: Anatomy Of the Auricular Branch Of The Vagus Nervementioning

confidence: 99%

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Murray

Atkinson

Mahadi

et al. 2016

Autonomic Neuroscience

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The human ear seems an unlikely candidate for therapies aimed at improving cardiac function, but the ear and the heart share a common connection: the vagus nerve. In recent years there has been increasing interest in the auricular branch of the vagus nerve (ABVN), a unique cutaneous subdivision of the vagus distributed to the external ear. Non-invasive electrical stimulation of this nerve through the skin may offer a simple, cost-effective alternative to the established method of vagus nerve stimulation (VNS), which requires a surgical procedure and has generated mixed results in a number of clinical trials for heart failure. This review discusses the available evidence in support of modulating cardiac activity using this strange auricular nerve.

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“…The cuff electrode is routinely used in the clinical setting for vagus nerve stimulation (VNS), which has been shown to be effective in the management of epilepsy [31,104], resistant depression [127], blood pressure control [110], as well as prevention of heart failure in patients with reduced ejection fractions [32,43,113]. Additionally, the Inspire® hypoglossal nerve stimulator, a Food and Drug Administration (FDA)- Fig.…”

Section: Cuff Electrodesmentioning

confidence: 99%

Interfacing with the nervous system: a review of current bioelectric technologies

et al. 2017

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The aim of this study is to discuss the state of the art with regard to established or promising bioelectric therapies meant to alter or control neurologic function. We present recent reports on bioelectric technologies that interface with the nervous system at three potential sites-(1) the end organ, (2) the peripheral nervous system, and (3) the central nervous system-while exploring practical and clinical considerations.

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Autonomic Regulation Therapy via Left or Right Cervical Vagus Nerve Stimulation in Patients With Chronic Heart Failure: Results of the ANTHEM-HF Trial

Abstract: Chronic open-loop ART via left- or right-side VNS is feasible and well tolerated in HFrEF patients. Safety and efficacy measures are encouraging and warrant further study.

Cited by 314 publications

References 40 publications

Neuro-cardiac interaction in malignant ventricular arrhythmia and sudden cardiac death

Neuro-cardiac interaction in malignant ventricular arrhythmia and sudden cardiac death

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Interfacing with the nervous system: a review of current bioelectric technologies

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