Safety and efficacy of baroreflex activation therapy for heart failure with reduced ejection fraction: a rapid systematic review

Abstract

To retrieve and assess the available data in the literature about the safety and efficacy of baroreflex activation therapy (BAT) in heart failure with reduced ejection fraction (HFrEF) patients, through a rapid systematic review of clinical studies. Rapid systematic review of literature. Searched electronic databases included PubMed, EMBASE, CENTRAL, Scopus, and Web of Science using Mesh and free terms for heart failure and BAT. No language restriction was used for the searches. We included full peer reviewed publications of clinical studies (randomized or not), including patients with HFrEF undergoing BAT, with or without control group, assessing safety and efficacy outcomes. One reviewer conducted the analysis of the selected abstracts and the full‐text articles, performed data extraction, and evaluated the methodological quality of the selected articles. The methodological quality was assessed according to the Cochrane Collaboration instruments. A descriptive summary of the results is provided. Of the 441 citations screened, 10 publications were included (three were only conference abstracts), reporting data from three studies. Only one study was a randomized clinical trial. Two studies reported a 6 month following, and the other study analysed outcomes up to 41 months. The procedure seems to be safe when performed by a well‐trained multi‐professional team. An 86% rate of system and procedure‐related complication‐free was reported, with no cranial nerve injuries. Improvements in New York Heart Association class of heart failure, quality of life, 6 min walk test, and hospitalization rates, as well as in muscle sympathetic nerve activity. No meta‐analysis was conducted because of the lack of homogeneity across studies; the results from each study are reported individually. BAT procedure seems to be safe if appropriate training is provided. Improvements in clinical outcomes were described in all included studies. However, several limitations do not allow us to make conclusive statements on the efficacy of BAT for HFrEF. New well‐designed trials are still needed.

Baroreflex Activation Therapy (BAT) Effectiveness Among Heart Failure Patients: A Systematic Review and Meta-Analysis

“…This http://eduvest.greenvest.co.id result is consistent with the previous review. They revealed that BAT lower hospitalization rates and the number of days hospitalization after treatment (Schmidt et al, 2020). In other meta-analysis settings, there was no explanation about the hospitalization effect after BAT because they just explain its impact on reduced blood pressure among chronic heart failure patients (Wallbach et al, 2016).…”

“…Our findings were consistent with the previous review. They also found that Baroreflex Activation Therapy (BAT) effectively improve NYHA class and 6-MHWD among heart failure patients (Schmidt, Rodrigues, Schmidt, & Irigoyen, 2020). Furthermore, in other settings, a meta-analysis was performed to identified the correlation of Baroreflex Activation Therapy (BAT) and reduced of blood pressure.…”

Efficacy and safety of baroreflex activation therapy for heart failure with reduced ejection fraction: systematic review

“…Using the AMSTAR 2 system (Data S3), the systematic reviews were classed as low quality, 16 critically low quality [17][18][19][20] or moderate. 21 According to RoB2 (Data S4), the clinical trials had an uncertain 26 or high 24 risk of bias.…”

“…The results of the systematic reviews [16][17][18][19][20][21] indicated that BAT is safe when performed by a well-trained multidisciplinary team. There were improvements in LVEF, NYHA class, quality of life, 6MWT, NT-proBNP levels, hospitalization rates and length of stay, and muscle sympathetic nerve activity.…”

Effects of resistance training on baroreflex sensitivity function in healthy males

“…Recently in Western countries, baroreflex activation therapy has been initiated in patients with heart failure to improve BRS, autonomic nervous system and cardiac functions as well as exercise tolerance 8 , 9 ) .…”