Vagus Nerve Stimulation for Treatment of Chronic Heart Failure
https://doi.org/10.35401/2541-9897-2025-10-1-136-143
Abstract
Background: Heart failure is the outcome of most cardiovascular diseases. Its prevalence continues to increase annually, which emphasizes the importance of developing therapeutic strategies to prevent adverse outcomes. This article reviews current data on the effect of vagus nerve stimulation on the course of chronic heart failure.
Objective: To summarize available literature data on the effect of vagus nerve stimulation on the course of chronic heart failure.
Materials and methods: We searched PubMed and eLIBRARY for the relevant information over the last 20 years using the following keywords: vagus nerve, heart failure, stimulation, ejection fraction. The search was performed by titles, abstracts, and keywords.
Results: This review revealed that vagus nerve stimulation has favorable effects in patients with heart failure and warrants further careful investigation.
About the Authors
Mariya V. KaribovaRussian Federation
Mariya V. Karibova, Cardiologist; Postgraduate Student, Therapy Department No. 1, Faculty of Continuing Professional Development and Retraining
ulitsa 1 Maya 167, Krasnodar, 350086
Sofiya V. Kruchinova
Russian Federation
Sofiya V. Kruchinova, Cand. Sci. (Med.), Cardiologist; Assistant Professor at the Therapy Department No. 1, Faculty of Continuing Professional Development and Retraining
ulitsa 1 Maya 167, Krasnodar, 350086
Vladimir A. Shvartz
Russian Federation
Vladimir A. Shvartz, Dr. Sci. (Med.), Cardiologist, Leading Researcher, Department of Surgical Treatment for Interactive Pathology, Professor at the Department of Cardiovascular Surgery with the Course of Arrhythmology and Clinical Electrophysiology
Moscow
Milana N. Gendugova
Russian Federation
Milana N. Gendugova, Cardiologist; Postgraduate Student, Therapy Department No. 1, Faculty of Continuing Professional Development and Retraining
ulitsa 1 Maya 167, Krasnodar, 350086
Elena D. Kosmacheva
Russian Federation
Elena D. Kosmacheva, Dr. Sci. (Med.), Deputy Chief Physician for Medical Work; Head of the Therapy Department No. 1, Faculty of Continuing Professional Development and Retraining
ulitsa 1 Maya 167, Krasnodar, 350086
References
1. Tepliakov AT, Dibirov MM, Bolotskaia LA, et al. Effect of carvedilol on blood levels of cytokines and symptoms of heart failure in patients with postinfarction cardiac dysfunction. Kardiologiia. 2004;44(9):50–57. (In Russ.). PMID: 15477776.
2. Frolova EB, Yaushev MF. Current understanding of chronic heart failure. The Bulletin of Contemporary Clinical Medicine. 2013;6(2):87– 93. (In Russ.). https://doi.org/10.20969/vskm.2013.6(2).87-93
3. Alieva AM, Baykova IE, Voronkova KV, et al. Gamma-glutamyl transpeptidase is a promising biological marker of heart failure. The Clinician. 2022;16(1):12–20. (In Russ.).
4. Smith WM. Epidemiology of congestive heart failure. Am J Cardiol. 1985;55(2):3A–8A. PMID: 3966408. https://doi.org/10.1016/0002-9149(85)90789-1
5. Polyakov DS, Fomin IV, Belenkov YN, et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study. Kardiologiia. 2021;61(4):4–14. (In Russ.). PMID: 33998403. https://doi.org/10.18087/cardio.2021.4.n1628
6. Benditt DG, Iskos D, Sakaguchi S. Chapter 3 - Autonomic nervous system and cardiac arrhythmias. In: Saksena S, Camm AJ, Boyden PA, Dorian P, Goldschlager N, eds. Electrophysiological Disorders of the Heart. Churchill Livingstone; 2005:49–67. https://doi.org/10.1016/B978-0-443-06570-5.50009-5
7. Sinelnikov RD, Sinelnikov YaR. Atlas of Human Anatomy. Vol. 4. Meditsina; 1996:133–139. (In Russ.).
8. Schwartz PJ, La Rovere MT, De Ferrari GM, Mann DL. Autonomic modulation for the management of patients with chronic heart failure. Circ Heart Fail. 2015;8(3):619–628. PMID: 25991804. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001964
9. Dusi V, De Ferrari GM. Vagal stimulation in heart failure. Herz. 2021;46(6):541–549. PMID: 34716778. PMCID: PMC8642334. https://doi.org/10.1007/s00059-021-05076-5
10. Desai MY, Watanabe MA, Laddu AA, Hauptman PJ. Pharmacologic modulation of parasympathetic activity in heart failure. Heart Fail Rev. 2011;16(2):179–193. PMID: 20924667. https://doi.org/10.1007/s10741-010-9195-1
11. Syrovnev VA, Lebedev DS, Mikhaylov EN. Vagus nerve stimulation in cardiology. Translational Medicine. 2017;4(2):6–16. (In Russ.). https://doi.org/10.18705/2311-4495-2017-4-2-6-16
12. Asconapé JJ, Moore DD, Zipes DP, Hartman LM, Duffell WH Jr. Bradycardia and asystole with the use of vagus nerve stimulation for the treatment of epilepsy: a rare complication of intraoperative device testing. Epilepsia. 1999;40(10):1452–1454. PMID: 10528943. https://doi.org/10.1111/j.1528-1157.1999.tb02019.x
13. Ventureyra EC. Transcutaneous vagus nerve stimulation for partial onset seizure therapy. A new concept. Childs Nerv Syst. 2000;16(2):101–102. PMID: 10663816. https://doi.org/10.1007/s003810050021
14. Peuker ET, Filler TJ. The nerve supply of the human auricle. Clin Anat. 2002;15(1):35–37. PMID: 11835542. https://doi.org/10.1002/ca.1089
15. Chen M, Yu L, Ouyang F, et al. The right side or left side of noninvasive transcutaneous vagus nerve stimulation: based on conventional wisdom or scientific evidence?. Int J Cardiol. 2015;187:44–45. PMID: 25828310. https://doi.org/10.1016/j.ijcard.2015.03.351
16. Butt MF, Albusoda A, Farmer AD, Aziz Q. The anatomical basis for transcutaneous auricular vagus nerve stimulation. J Anat. 2020;236(4):588–611. PMID: 31742681. PMCID: PMC7083568. https://doi.org/10.1111/joa.13122
17. Ben-Menachem E, Revesz D, Simon BJ, Silberstein S. Surgically implanted and non-invasive vagus nerve stimulation: a review of efficacy, safety and tolerability. Eur J Neurol. 2015;22(9):1260–1268. PMID: 25614179. PMCID: PMC5024045. https://doi.org/10.1111/ene.12629
18. Nicholson WC, Kempf MC, Moneyham L, Vance DE. The potential role of vagus-nerve stimulation in the treatment of HIV-associated depression: a review of literature. Neuropsychiatr Dis Treat. 2017;13:1677–1689. PMID: 28721049. PMCID: PMC5499939. https://doi.org/10.2147/NDT.S136065
19. Verma N, Mudge JD, Kasole M, et al. Auricular vagus neuromodulation-a systematic review on quality of evidence and clinical effects. Front Neurosci. 2021;15:664740. PMID: 33994937. PMCID: PMC8120162. https://doi.org/10.3389/fnins.2021.664740
20. Stavrakis S, Elkholey K, Morris L, Niewiadomska M, Asad ZUA, Humphrey MB. Neuromodulation of inflammation to treat heart failure with preserved ejection fraction: a pilot randomized clinical trial. J Am Heart Assoc. 2022;11(3):e023582. PMID: 35023349. PMCID: PMC9238491. https://doi.org/10.1161/JAHA.121.023582
21. Zhou L, Filiberti A, Humphrey MB, et al. Low-level transcutaneous vagus nerve stimulation attenuates cardiac remodelling in a rat model of heart failure with preserved ejection fraction. Exp Physiol. 2019;104(1):28–38. PMID: 30398289. PMCID: PMC6312463. https://doi.org/10.1113/EP087351
22. Konstam MA, Mann DL, Udelson JJE, et al. Advances in our clinical understanding of autonomic regulation therapy using vagal nerve stimulation in patients living with heart failure. Front Physiol. 2022;13:857538. PMID: 35530511. PMCID: PMC9068946. https://doi.org/10.3389/fphys.2022.857538
23. Einbrodt. Über Herzreizung und ihr Verhältniss zum Blutdruck. Sitzungsberichte der Akademie der Wissenschaften mathematisch-naturwissenschaftliche Klasse. 1860;38:345–359. (In German).
24. Yoon MS, Han J, Tse WW, Rogers R. Effects of vagal stimulation, atropine, and propranolol on fibrillation threshold of normal and ischemic ventricles. Am Heart J. 1977;93(1):60–65. PMID: 831412. https://doi.org/10.1016/s0002-8703(77)80172-5
25. Kolman BS, Verrier RL, Lown B. The effect of vagus nerve stimulation upon vulnerability of the canine ventricle: role of sympathetic-parasympathetic interactions. Circulation. 1975;52(4):578–585. PMID: 239801. https://doi.org/10.1161/01.cir.52.4.578
26. Kent KM, Smith ER, Redwood DR, Epstein SE. Electrical stability of acutely ischemic myocardium. Influences of heart rate and vagal stimulation. Circulation. 1973;47(2):291–298. PMID: 4684930. https://doi.org/10.1161/01.cir.47.2.291
27. Myers RW, Pearlman AS, Hyman RM, et al. Beneficial effects of vagal stimulation and bradycardia during experimental acute myocardial ischemia. Circulation. 1974;49(5):943–947. PMID: 4828616. https://doi.org/10.1161/01.cir.49.5.943
28. Vanoli E, De Ferrari GM, Stramba-Badiale M, Hull SS Jr, Foreman RD, Schwartz PJ. Vagal stimulation and prevention of sudden death in conscious dogs with a healed myocardial infarction. Circ Res. 1991;68(5):1471–1781. PMID: 2019002. https://doi.org/10.1161/01.res.68.5.1471
29. Li M, Zheng C, Sato T, Kawada T, Sugimachi M, Sunagawa K. Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats. Circulation. 2004;109(1):120–124. PMID: 14662714. https://doi.org/10.1161/01.CIR.0000105721.71640.DA
30. Zhang Y, Popovic ZB, Bibevski S, et al. Chronic vagus nerve stimulation improves autonomic control and attenuates systemic inflammation and heart failure progression in a canine high-rate pacing model. Circ Heart Fail. 2009;2(6):692–699. PMID: 19919995. https://doi.org/10.1161/CIRCHEARTFAILURE.109.873968
31. Sabbah HN, Ilsar I, Zaretsky A, Rastogi S, Wang M, Gupta RC. Vagus nerve stimulation in experimental heart failure. Heart Fail Rev. 2011;16(2):171–178. PMID: 21128115. PMCID: PMC3784341. https://doi.org/10.1007/s10741-010-9209-z
32. Wu Z, Liao J, Liu Q, Zhou S, Chen M. Chronic vagus nerve stimulation in patients with heart failure: challenge or failed translation?. Front Cardiovasc Med. 2023;10:1052471. PMID: 37534273. PMCID: PMC10390725. https://doi.org/10.3389/fcvm.2023.1052471
33. Hamann JJ, Ruble SB, Stolen C, et al. Vagus nerve stimulation improves left ventricular function in a canine model of chronic heart failure. Eur J Heart Fail. 2013;15(12):1319–1326. PMID: 23883651. PMCID: PMC3895958. https://doi.org/10.1093/eurjhf/hft118
34. Li M, Zheng C, Kawada T, Inagaki M, Uemura K, Sugimachi M. Chronic vagal nerve stimulation exerts additional beneficial effects on the beta-blocker-treated failing heart. J Physiol Sci. 2019;69(2):295–303. PMID: 30414045. PMCID: PMC10717668. https://doi.org/10.1007/s12576-018-0646-0
35. Schwartz PJ, De Ferrari GM, Sanzo A, et al. Long term vagal stimulation in patients with advanced heart failure: first experience in man. Eur J Heart Fail. 2008;10(9):884–891. PMID: 18760668. https://doi.org/10.1016/j.ejheart.2008.07.016
36. De Ferrari GM, Crijns HJ, Borggrefe M, et al; CardioFit Multicenter Trial Investigators. Chronic vagus nerve stimulation: a new and promising therapeutic approach for chronic heart failure. Eur Heart J. 2011;32(7):847–855. PMID: 21030409. https://doi.org/10.1093/eurheartj/ehq391
37. Zannad F, De Ferrari GM, Tuinenburg AE, et al. Chronic vagal stimulation for the treatment of low ejection fraction heart failure: results of the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) randomized controlled trial. Eur Heart J. 2015;36(7):425–433. PMID: 25176942. PMCID: PMC4328197. https://doi.org/10.1093/eurheartj/ehu345
38. Premchand RK, Sharma K, Mittal S, et al. Extended follow-up of patients with heart failure receiving autonomic regulation therapy in the ANTHEM-HF study. J Card Fail. 2016;22(8):639–642. PMID: 26576716. https://doi.org/10.1016/j.cardfail.2015.11.002
39. Gold MR, Van Veldhuisen DJ, Hauptman PJ, et al. Vagus nerve stimulation for the treatment of heart failure: the INOVATE-HF trial. J Am Coll Cardiol. 2016;68(2):149–158. PMID: 27058909. https://doi.org/10.1016/j.jacc.2016.03.525
40. Anand IS, Konstam MA, Klein HU, et al. Comparison ofsymptomatic and functional responses to vagus nerve stimulation in ANTHEM-HF, INOVATE-HF, and NECTAR-HF. ESC Heart Fail. 2020;7(1):75–83. PMID: 31984682. PMCID: PMC7083506. https://doi.org/10.1002/ehf2.12592
41. Cowie MR, Wood DA, Coats AJ, et al. Incidence and aetiology of heart failure; a population-based study. Eur Heart J. 1999;20(6):421–428. PMID: 10213345. https://doi.org/10.1053/euhj.1998.1280
42. Gavryushina SV, Ageev FT. Heart failure with preserved left ventricular ejection fraction: epidemiology, patient «portrait»,clinic and diagnostics. Kardiologiia. 2018;58(4S):55–64. (InRuss.). https://doi.org/10.18087/cardio.2467
43. Shah SJ, Kitzman DW, Borlaug BA, et al. Phenotype-specific treatment of heart failure with preserved ejection fraction: a multiorgan roadmap. Circulation. 2016;134(1):73–90. PMID: 27358439. PMCID: PMC4930115. https://doi.org/10.1161/CIRCULATIONAHA.116.021884.
Review
For citations:
Karibova M.V., Kruchinova S.V., Shvartz V.A., Gendugova M.N., Kosmacheva E.D. Vagus Nerve Stimulation for Treatment of Chronic Heart Failure. Innovative Medicine of Kuban. 2025;10(1):136-143. (In Russ.) https://doi.org/10.35401/2541-9897-2025-10-1-136-143