Harvard Heart Letter

On the horizon: Targeting nerves to heal the heart

Drug therapy and surgery have long focused on the arteries — and what happens inside of them — to control cardiovascular disease. Researchers are now taking a new look at nerves as a target for treating cardiovascular conditions such as heart failure and high blood pressure.

Two sets of nerves, the sympathetic and vagal nerves, counterbalance each other. The sympathetic system boosts the heart rate and blood pressure while the vagal system lowers heart rate and blood pressure. These systems work together to help the body respond to minute-to-minute changes called for by the demands of life.

In people with heart failure, overactivation of the sympathetic nervous system keeps the heart rate and blood pressure high. This makes the heart work harder, which, in turn, further weakens the heart and worsens heart failure. An Israeli company called BioControl has fashioned a pacemaker-like device called CardioFit that stimulates the vagal nerves. Preliminary results show that the device significantly lowers heart rate, which would be expected to improve heart function, ease heart failure symptoms, and improve quality of life. Larger clinical trials of the device are underway. Devices that stimulate the vagus nerve have already been approved for preventing seizures in people with epilepsy and for treating drug-resistant clinical depression.

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