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A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS ON VAGUS NERVE STIMULATION FOR THE HEART FAILURE MANAGEMENT
815 JACC March 21, 2017 Volume 69, Issue 11
Heart Failure and Cardiomyopathies A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS ON VAGUS NERVE STIMULATION FOR THE HEART FAILURE MANAGEMENT Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m. Session Title: Heart Failure and Cardiomyopathies: Heart Failure Gadgets Galore Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy Presentation Number: 1199-254 Authors: Gilson Fernandes, Amanda Fernandes, Rhanderson Cardoso, Manuel Rivera, Guilherme Nasi, Gustavo Soares Fernandes, University of Miami/Jackson Memorial Hospital, Miami, FL, USA
Background: Vagus nerve stimulation (VNS) acts by providing augmentation of parasympathetic tone with the theoretical effect of inhibiting progression of heart failure. We aimed to perform a meta-analysis comparing VNS with medical therapy for the management of heart failure with reduced ejection fraction (HFrEF).
Methods: PubMed, Embase and the Cochrane Central Registry of Controlled Trials were searched for RCTs that compared VNS systems with guideline-directed medical therapy (GDMT) for management of HFrEF. Efficacy and safety data were summarized using fixed effect model predicting low heterogeneity between studies. Results: Three RCTs were included, totalizing 575 patients treated with VNS and 373 patients on GDMT. VNS was associated with significant improvement of NYHA functional class (OR 2.36; p<0.01). Freedom from adverse events was observed in 89.4% of patients implanted with the device. There was no significant difference in mortality between groups (OR 1.32; p=0.21). VNS was associated with significant improvement of quality of life and exercise capacity on the individual studies.
Conclusions: VNS was shown to significantly improve the NYHA functional class of patients with HFrEF. VNS was safe, but there was no impact in terms of mortality benefit.
Heart Failure and Cardiomyopathies A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS ON VAGUS NERVE STIMULATION FOR THE HEART FAILURE MANAGEMENT Poster Contributions Poster Hall, Hall C Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m. Session Title: Heart Failure and Cardiomyopathies: Heart Failure Gadgets Galore Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy Presentation Number: 1199-254 Authors: Gilson Fernandes, Amanda Fernandes, Rhanderson Cardoso, Manuel Rivera, Guilherme Nasi, Gustavo Soares Fernandes, University of Miami/Jackson Memorial Hospital, Miami, FL, USA
Background: Vagus nerve stimulation (VNS) acts by providing augmentation of parasympathetic tone with the theoretical effect of inhibiting progression of heart failure. We aimed to perform a meta-analysis comparing VNS with medical therapy for the management of heart failure with reduced ejection fraction (HFrEF).
Methods: PubMed, Embase and the Cochrane Central Registry of Controlled Trials were searched for RCTs that compared VNS systems with guideline-directed medical therapy (GDMT) for management of HFrEF. Efficacy and safety data were summarized using fixed effect model predicting low heterogeneity between studies. Results: Three RCTs were included, totalizing 575 patients treated with VNS and 373 patients on GDMT. VNS was associated with significant improvement of NYHA functional class (OR 2.36; p<0.01). Freedom from adverse events was observed in 89.4% of patients implanted with the device. There was no significant difference in mortality between groups (OR 1.32; p=0.21). VNS was associated with significant improvement of quality of life and exercise capacity on the individual studies.
Conclusions: VNS was shown to significantly improve the NYHA functional class of patients with HFrEF. VNS was safe, but there was no impact in terms of mortality benefit.