Baroreflex activation therapy for the treatment of heart failure

Baroreflex activation therapy (BAT) results in centrally mediated reduction of sympathetic outflow and increased parasympathetic activity to the heart via a physiological reflex pathway. In a pilot study in 11 NYHA Class III heart failure (HF) patients, BAT produced a persistent significant reduction of sympathetic activity over 21 months follow-up and a dramatic decrease in the number and length of hospitalizations. In a multinational, prospective, randomized, parallel-controlled, clinical trial in 146 NYHA Class III HF patients, BAT produced a significant N-terminal pro-brain natriuretic peptide reduction (p <0.02). This was associated with a trend toward fewer in-hospital days for HF. BAT might become a powerful tool to repair autonomic alterations due to HF at their origin and thus, profoundly affect the prognosis of advanced HF patients.