NECTAR HF: Chronic vagal stimulation for heart failure with low ejection fraction

The increased sympathetic activity and reduced parasympathetic tone are important pathophysiological contributors to the progression of heart failure and are associated with a worse prognosis. The aim of this study was to determine if vagus nerve stimulation is a promising strategy to modulate autonomic function, cardiac remodeling, and progression of heart failure. 

The NECTAR HF (cardiac neural therapy for heart failure) is a study designed to evaluate the safety and efficacy of the Boston Scientific device to attenuate cardiac remodeling, improved cardiac function and increase exercise capacity in patients with symptomatic heart failure (functional Class II-III), left ventricular dysfunction (ejection fraction ≤35%) receiving optimized medical treatment.

Patients were randomized 2: 1 to optimal medical therapy plus the device in active mode versus optimal medical therapy plus the device in sleep mode for 6 months. After 6 months activation of the devices was performed in idle mode. At the end of the monitoring period no clinical benefit with vagus nerve stimulation was observed but neither security issues, so it must be further investigated in this line of treatment.

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Zannad F
2014-08-31

Original title: A randomized controlled trial of vagal stimulation for the treatment of systolic heart failure: NEural Cardiac TherApyfoR Heart Failure (NECTAR-HF).

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