Electrical Stimulation and Cardiovascular Disease : A Novel Therapeutic Approach

Electrical stimulation (ES) is an established method for providing muscle activity. Moreover, there are some reports that ES induces angiogenesis. It was thought that the angiogenesis from ES is induced by physical phenomenon such as calculated shear stress, capillary wall tension, and stretch. However, there is a report that the electrical field itself might play a role in angiogenesis by stimulating the vascular endothelial growth factor (VEGF) receptor signaling pathway. Therefore, there is a possibility that ES might be used as a new therapy for ischemic diseases such as arteriosclerosis obliterans (ASO). The limited physical performance of chronic heart failure (CHF) patients may not only be entirely due to impairment of cardiac and lung function but may also result from peripheral hemodynamic variables and abnormalities in skeletal muscle metabolism and structure, such as a decrease in capillary density, mitochondrial content etc. There are some studies showing the positive effect of low frequency electrical stimulation on muscle strength and blood flow in patients who have advanced CHF and can not achieve conventional exercise training. Thus, ES could be recommended for the treatment of patients with severe CHF. Furthermore, cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker would reduce the risk of death and hospitalization among patients with advanced CHF. Further studies are required to precisely define the underlying mechanism and determine the most effective mode of application.