A Novel Automated Algorithm Effectively Titrates Stimulation in an Implantable Vagus Nerve Stimulation Device

Badri Amurthur,Scott Mazar,Lorenzo DiCarlo,Bruce H KenKnight,Enea Dede,Scott Stubbs,Imad Libbus

doi:10.23937/2378-3001/1410105

Abstract

Autonomic Regulation Therapy (ART) using chronic Vagus Nerve Stimulation (VNS) is in development for patients with heart failure who remain symptomatic despite standard care. In the ANTHEM-HF Pilot Study, a therapeutic VNS intensity was successfully achieved in patients with HFrEF using manually programmed VNS up-titration. An algorithm has been developed for automatically intensifying VNS in small increments to a programmable target intensity, and capable of adjustments during the up-titration process using a hand-held programmer or magnet.

Highlights

Autonomic regulation of cardiac function is a complex process involving hierarchical interactions among central and peripheral neural networks that are comprised of sympathetic and parasympathetic elements of the autonomic nervous system [1]
In chronic heart failure (HF), as heart pumping function becomes impaired, the autonomic nervous system attempts to compensate by increasing sympathetic activation and reducing central outflow of parasympathetic activity [2]
All animals were successfully implanted with the VITARIA System

Summary

Introduction

Autonomic regulation of cardiac function is a complex process involving hierarchical interactions among central and peripheral neural networks that are comprised of sympathetic and parasympathetic elements of the autonomic nervous system [1]. In chronic heart failure (HF), as heart pumping function becomes impaired, the autonomic nervous system attempts to compensate by increasing sympathetic activation and reducing central outflow of parasympathetic activity [2]. This helps maintain cardiac output; prolonged sympathetic hyper activation is associated with maladaptive cardiovascular responses that promote HF progression and worse outcomes [3,4]. Autonomic Regulation Therapy (ART) using chronic Vagus Nerve Stimulation (VNS) is in development for patients with heart failure who remain symptomatic despite standard care. An algorithm has been developed for automatically intensifying VNS in small increments to a programmable target intensity, and capable of adjustments during the up-titration process using a hand-held programmer or magnet

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Conclusion