The outcomes of mortality and morbidity for the patients admitted for acute decompensated heart failure (HF) are poor and have remained consistent for decades. Therapies practiced currently are fixed upon symptom relief by tackling the symptoms and signs of congestion. The prime objective of this study was to examine the novel neuromodulation therapy of stimulation of the epicardial cardiac nerves that pass alongside the dorsal surface of the right pulmonary artery.
In total, fifteen patients admitted for ejection fraction ≤35% and defibrillator implantation on conventional HF medications were enlisted. After the electro anatomic rendering of the pulmonary artery and branches, either a basket or circular electrophysiology catheter was placed in the right pulmonary artery to allow intravascular electrical stimulation at ≤20 mA, 4 ms pulse width, and at 20 Hz. The changes in maximum positive dP/dt (dP/dtMax) indicated changes in ventricular contractility. However, five patients could not be studied due to abnormal pulmonary arterial anatomy or equipment failure. In the remaining subjects, an increase of about 22.6% was observed for the value of dP/dtMax.
In this first-in-human study, we demonstrated that left ventricular contractility in humans with stable HF could be accentuated without an increase in heart rate or left ventricular filling pressures. This safe increase in contractility might benefit the patients admitted for acute decompensated HF.
Ref: https://www.ahajournals.org/doi/10.1161/CIRCEP.120.008407
