Vagal nerve stimulation for the treatment of heart failure

Abstract

Despite the availability of several different therapies, heart failure remains a leading cause of death worldwide, with high mortality and morbidity rates. One prognostically important feature of heart failure, that remains unaltered by conventional therapy, is vagal withdrawal. Vagal nerve stimulation (VNS) allows the direct manipulation of vagal tone, via implantable pulse generators. Deemed both safe and tolerable for human use, pre-clinical and clinical data indicate promising improvements of left ventricular function with chronic VNS therapy. Despite several proposed mechanisms, little is understood about how the cardioprotective effect is mediated, leaving several unanswered questions for ongoing research and clinical trials.