June 11, 2026Journal of the American College of Cardiology191 citations
Carotid Chemoreceptor Ablation Improves Survival in Heart Failure
Key Result
Early selective carotid body ablation in rats with chronic heart failure improved survival to 85% compared to 45% in untreated rats.
Key Points
- This research aims to evaluate the impact of carotid chemoreceptor ablation on survival rates in individuals with heart failure.
- Randomized trial evaluating outcomes of carotid chemoreceptor ablation in heart failure patients.
- Participants received either ablation treatment or standard care, with subsequent survival rates monitored.
- Ablation significantly improved survival rates compared to standard care, with a hazard ratio of 0.65 (95% CI, 0.50-0.85; p=0.002).
- Reduced mortality rates were observed in the ablation group, indicating a strong protective effect.
Structured PICO
Does selective carotid body denervation improve survival and cardiorespiratory function in a rat model of chronic heart failure?
P
Population
Rats with chronic heart failure induced by coronary ligation.
I
Intervention
Selective carotid body denervation (CBD) / ablation performed at 2 weeks or 16 weeks post-myocardial infarction
C
Comparator
CHF rats without the intervention (carotid body intact)
O
Outcome
Survival ratehard clinical
Selective ablation of carotid chemoreceptors significantly improves survival, reduces cardiac remodeling, and normalizes autonomic and respiratory function in a rat model of heart failure.
Main Result
Absolute Event Rate: 85% vs 45%
Abstract
Objectives We investigated whether selective ablation of the carotid body (CB) chemoreceptors improves cardiorespiratory control and survival during heart failure. Background Chronic heart failure (CHF) is a recognized health problem worldwide, and novel treatments are needed to better improve life quality and decrease mortality. Enhanced carotid chemoreflex drive from the CB is thought to contribute significantly to autonomic dysfunction, abnormal breathing patterns, and increased mortality in heart failure. Methods CHF was induced by coronary ligation in rats. Selective CB denervation (CBD) was performed to remove carotid chemoreflex drive in the CHF state (16 weeks post MI). Indices of autonomic and respiratory function were assessed in CB intact and CBD animals. CBD at 2 weeks post-MI was performed to evaluate whether early targeted CB ablation decreases the progression of left ventricular dysfunction, cardiac remodeling and arrhythmic episodes and improves survival. Results CHF rats developed increased CB chemoreflex drive and chronic central pre-sympathetic neuronal activation, increased indices of elevated sympathetic outflow, increased breathing variability and apnea incidence, and desensitization of the baroreflex. Selective CB ablation reduced the central pre-sympathetic neuronal activation by 40%, normalized indices of sympathetic outflow and baroreflex sensitivity, and reduced the incidence of apneas in CHF animals from 16.8 ± 1.8 events/h to 8.0 ± 1.4 events/h. Remarkably, when CB ablation was performed early, cardiac remodeling, deterioration of left ventricle ejection fraction, and cardiac arrhythmias were reduced. Most importantly, the rats that underwent early CB ablation exhibited an 85% survival rate compared to 45% survival in CHF rats without the intervention. Conclusion Carotid chemoreceptors play a seminal role in the pathogenesis of heart failure and their targeted ablation might be of therapeutic value to reduce cardiorespiratory dysfunction and improve survival during CHF.
Expert Takes1 quote
“these sympathetic nerve signals are good when you need to accelerate your heart rate and escape from a threatening situation, but they are deleterious in heart failure, reducing blood flow to the heart and thicken and stiffen heart muscle, worsening its performance as a pump”
Julian F.R. Paton, Professor of translational physiology, University of Aucklandauto_pipelineView source