Long term vagal stimulation in patients with advanced heart failure. First experience in man

Peter J. Schwartz, Gaetano M. De Ferrari, Antonio Sanzo, Maurizio Landolina, Roberto Rordorf, Claudia Raineri, Carlo Campana, Miriam Revera, Nina Ajmone-Marsan, Luigi Tavazzi, Attilio Odero

Research output: Contribution to journalArticlepeer-review


Background: Experimentally, vagal stimulation (VS) is protective in chronic heart failure (HF). In man, VS is used in refractory epilepsy but has never been used in cardiovascular diseases. Increased sympathetic and reduced vagal activity predict increased mortality in HF. Aims: This pilot study assessed feasibility and safety and tested possible efficacy of chronic VS in HF patients. Methods: We studied 8 patients (mean age 54 years). CardioFit (BioControl Medical), a VS implantable system delivering pulses synchronous with heart beats through a multiple contact bipolar cuff electrode, was used. VS was started 2-4 weeks after implant, slowly raising intensity; patients were followed 1, 3 and 6 months thereafter. Results: All procedures were successful: as sole surgical side effect, one patient had transient hoarseness. VS was well tolerated, with only mild side effects (cough and sensation of electrical stimulation). There was a significant improvement in NYHA class, Minnesota quality of life® (from 52 ± 14 to 31 ± 18, p <0.001), left ventricular end-systolic volume (from 208 ± 71 to 190 ± 83 ml, p = 0.03), and a favourable trend toward reduction in end-diastolic volume. Conclusions: This novel approach to the treatment of patients with HF is feasible, and appears safe and tolerable. The preliminary efficacy results appear promising. These findings suggest the opportunity to proceed with a larger multicentre study.

Original languageEnglish
Pages (from-to)884-891
Number of pages8
JournalEuropean Journal of Heart Failure
Issue number9
Publication statusPublished - Sep 2008


  • Autonomic nervous system
  • Cardiomyopathy
  • Heart failure
  • Vagus nerve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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