Therapeutic responsiveness to vagus nerve stimulation in patients receiving beta-blockade for heart failure with reduced ejection fraction

• Published in: International journal of cardiology. Heart & vasculature 2021-12, Vol.37, p.100888-100888, Article 100888
• Main Authors: Dede, Enea, Gregory, Douglas D., Ardell, Jeffrey L., Libbus, Imad, DiCarlo, Lorenzo A., Premchand, Rajendra K., Sharma, Kamal, Mittal, Sanjay, Monteiro, Rufino, Anand, Inder S., Düngen, Hans-Dirk
• Format: Article
• Language: English
• Subjects: Autonomic nervous system; Autonomic regulation therapy; Beta blockers; Heart failure; Original Paper; Sympathetic blockade; Vagus nerve stimulation
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2021.100888

The effect of beta-blockade (BB) on response to vagus nerve stimulation (VNS) has not been reported in patients with heart failure and reduced ejection fraction (HFrEF). In the ANTHEM-HF Study, 60 patients received chronic cervical VNS. Background pharmacological therapy remained unchanged during the study, and VNS intensity was stable once up-titrated. Significant improvement from baseline occurred in resting 24-hour heart rate (HR), 24-hour HR variability (SDNN), left ventricular EF (LVEF), 6-minute walk distance (6MWD), and quality of life (MLWHFS) at 6 months post-titration. We evaluated whether response to VNS was related to percentage of target BB dose (PTBBD) at baseline. Patients were categorized by baseline PTBBD, then analyzed for changes from baseline in symptoms and function at 6 months after VNS titration. All patients received BB, either PTBBD ≥ 50 % (16 patients, 27 %; group 1) or PTBBD