Autonomic regulation therapy for the improvement of left ventricular function and heart failure symptoms: the ANTHEM-HF study

Abstract

Background: Outcomes of heart failure (HF) have improved dramatically with the use of blockers of the sympathetic and renin-angiotensin-aldosterone systems, as well as with more prevalent use of implantable cardiac defibrillators and cardiac resynchronization therapy. Despite these interventions, however, the overall prognosis of HF patients remains poor. Recently, stimulation of the right cervical vagus nerve in patients with symptomatic heart failure has been evaluated. Results suggest that vagal nerve stimulation provides sustained improvement in left ventricular (LV) function and symptoms associated with HF. However, much remains to be learned about the risks and benefits of therapies that alter autonomic regulatory function for the treatment of heart failure.

Methods: The Autonomic Neural Regulation Therapy to Enhance Myocardial Function in Heart Failure (ANTHEM-HF) study has been designed to address several key clinical questions about the role of autonomic regulation therapy (ART) in patients with LV dysfunction and chronic symptomatic heart failure.

Conclusions: ANTHEM-HF should provide additional and valuable information regarding the safety and the relationship between the site and intensity of ART and its salutary effects on HF.

Trial registration: ClinicalTrials.gov NCT01823887.

Keywords: Vagus nerve; autonomic balance; neural stimulation.