Key result
Neuromodulation therapies targeting autonomic control of the heart offer an alternative device-based approach for heart failure, though clinical trials have yielded mixed results to date.
Understanding the structural and functional organisation of the cardiac nervous system is important as mechanistic-based neuromodulation therapies for heart failure evolve.
Mixed HF neuromodulation trial results warrant clinical caution; leaves open the value of mapping cardiac autonomic organization for future targeted therapies.
Heart failure (HF) is associated with significant morbidity and mortality. The disease is characterised by autonomic imbalance with increased sympathetic activity and withdrawal of parasympathetic activity. Despite the use of medical therapies that target, in part, the neurohormonal axis, rates of HF progression, morbidity and mortality remain high. Emerging therapies centred on neuromodulation of autonomic control of the heart provide an alternative device-based approach to restoring sympathovagal balance. Preclinical studies have proven favourable, while clinical trials have had mixed results. This article highlights the importance of understanding structural/functional organisation of the cardiac nervous system as mechanistic-based neuromodulation therapies evolve.
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Hanna et al. (2018) conducted a review in Heart failure. Neuromodulation therapies was evaluated. Neuromodulation therapies targeting autonomic control of the heart offer an alternative device-based approach for heart failure, though clinical trials have yielded mixed results to date.
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