Thoracic Spinal Cord Stimulation for Heart Failure as a Restorative Treatment (SCS HEART study): First-in-man experience

Tse, Hung‐Fat; Turner, Stephen; Sanders, Prashanthan; Okuyama, Yuji; Fujiu, Katsuhito; Cheung, Chi-Wai; Russo, Marc; Green, Matthew D.S.; Yiu, Kai‐Hang; Chen, Peter; Shuto, Chika; Lau, Elizabeth; Siu, Chung‐Wah

doi:10.1016/j.hrthm.2014.12.014

Cited by 99 publications

(69 citation statements)

References 36 publications

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“…Similar findings were observed with SCS in a porcine animal model of ischemia and reperfusion [28]. Recently, Tse et al [29] reported the results of the SCS HEART study, which evaluated the safety and efficacy of a SCS system for the treatment of systolic HF. All the patients had a LVEF of 20-35% with NYHA class III.…”

Section: Es-pns and Hfsupporting

confidence: 65%

Autonomic Modulation by Electrical Stimulation of the Parasympathetic Nervous System: An Emerging Intervention for Cardiovascular Diseases

et al. 2016

Cardiovascular Therapeutics

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SUMMARYThe cardiac autonomic nervous system has been known to play an important role in the development and progression of cardiovascular diseases. Autonomic modulation by electrical stimulation of the parasympathetic nervous system, which increases the parasympathetic activity and suppresses the sympathetic activity, is emerging as a therapeutic strategy for the treatment of cardiovascular diseases. Here, we review the recent literature on autonomic modulation by electrical stimulation of the parasympathetic nervous system, including vagus nerve stimulation, transcutaneous auricular vagal stimulation, spinal cord stimulation, and ganglionated plexi stimulation, in the treatment of heart failure, atrial fibrillation, and ventricular arrhythmias.The cardiac autonomic nervous system, consisting of the sympathetic and the parasympathetic components, has been shown to play an important role in many cardiovascular diseases, such as heart failure, hypertension, atrial fibrillation, and ventricular arrhythmias [1][2][3][4]. An increased sympathetic nerve activity and a reduction of vagal cardiac tone are shown to be pathogenic in most of these conditions. In light of the autonomic imbalance involved in the development and progression of cardiovascular diseases, therapeutic interventions are focused on the inhibition of the sympathetic activation such as the use of b-receptor blockers, cardiac sympathetic denervation, and renal sympathetic denervation, and the increase of the parasympathetic activity such as vagus nerve stimulation. During the last decades, dysregulation of the autonomic nervous system in cardiovascular diseases has received considerable attention and interventions aiming at autonomic rebalance are emerging as new therapeutic options for the management of cardiovascular diseases. Autonomic modulation by electrical stimulation of the autonomic nervous system has been used clinically in patients with intractable angina pectoris [5][6][7], epilepsy [8], and depression [9,10]. Here, we review the experimental studies and clinical trials that are focused on autonomic modulation by electrical stimulation of the parasympathetic nervous system (ES-PNS), including vagus nerve stimulation (VNS), transcutaneous auricular vagal stimulation (tragus stimulation, TS), spinal cord stimulation (SCS), and ganglionated plexi stimulation (GPS), in the treatment of heart failure (HF), atrial fibrillation (AF), and ventricular arrhythmias (VAs). ES-PNS and HFSympathetic activation and parasympathetic withdrawal are the characteristics of autonomic imbalance in HF [2,11,12] [19], the ANTHEM-HF Trial, in which either left or right VNS was performed using an open-loop stimulation system. However, another randomized controlled trial, the NECTAR-HF trial [20], in which 96 symptomatic HF patients were randomized in a 2:1 ratio to receive VNS or control for a 6-month period, showed that VNS failed to significantly improve the primary and secondary endpoint measures of cardiac remodeling and functional capacity, even though quality-...

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Section: Es-pns and Hfsupporting

confidence: 65%

Autonomic Modulation by Electrical Stimulation of the Parasympathetic Nervous System: An Emerging Intervention for Cardiovascular Diseases

et al. 2016

Cardiovascular Therapeutics

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“…2,3 Recently, the SCS HEART study also showed that SCS was of benefit to heart failure patients. 23 However, the result of a single blinded randomized controlled trial of SCS for heart failure (DEFEAT-HF trial) was negative in terms of changes in left ventricular end-systolic volume index, brain natriuretic peptide level, and VAs. 34 Nonetheless, there are significant differences between these 2 trials.…”

Section: Discussionmentioning

confidence: 99%

“…Lopshire et al 3 showed that SCS significantly reduced the incidence of spontaneous VT with better efficacy compared with beta-blockers in a canine postinfarction heart failure model. Recently, Tse et al 23 showed that SCS might tend to reduce VAs in heart failure patients. Although both preclinical and clinical studies have shown that SCS could exert an antiarrhythmic effect, 2,3,23,24 the authors attributed the effect to autonomic modulation with sympathicolytic and parasympathicomimetic actions.…”

Section: Scs Facilitates Autonomic Rebalance and Reduces Vasmentioning

confidence: 99%

Spinal cord stimulation protects against ventricular arrhythmias by suppressing left stellate ganglion neural activity in an acute myocardial infarction canine model

et al. 2015

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“…36 Based on the above preclinical models, several clinical studies have been conducted in patients with HF. The Spinal Cord Stimulation for Heart Failure (SCS HEART) study 37 implanted a SCS device in 17 patients with NYHA class III HF, programmed to provide SCS for 24 hours a day (50 Hz at pulse width 200 μs). Patient safety was the primary end point of the study.…”

Section: Spinal Cord Stimulationmentioning

confidence: 99%

Autonomic Modulation for the Management of Patients with Chronic Heart Failure

Schwartz

Rovere

Ferrari

et al. 2015

Circ: Heart Failure

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and has shown anti-inflammatory effects.16 Indeed, the antiinflammatory effects of VS after ischemia and reperfusion injury are accompanied by a reduction in the number of macrophages and apoptotic cells that is paralleled by decreased levels of circulating proinflammatory cytokines. 17 These data point to the likely clinical relevance of the so-called cholinergic anti-inflammatory reflex proposed by Tracey. 18(Circ Heart Fail. 2015;8:619-628.

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Thoracic Spinal Cord Stimulation for Heart Failure as a Restorative Treatment (SCS HEART study): First-in-man experience

Cited by 99 publications

References 36 publications

Autonomic Modulation by Electrical Stimulation of the Parasympathetic Nervous System: An Emerging Intervention for Cardiovascular Diseases

Autonomic Modulation by Electrical Stimulation of the Parasympathetic Nervous System: An Emerging Intervention for Cardiovascular Diseases

Spinal cord stimulation protects against ventricular arrhythmias by suppressing left stellate ganglion neural activity in an acute myocardial infarction canine model

Autonomic Modulation for the Management of Patients with Chronic Heart Failure

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