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Bristol researchers offer new hope for people with heart failure

An image of the device (implanted on the right side of the chest)

An image of the device (implanted on the right side of the chest)

An image of the pulse generator (approved for use in pain management / spinal cord stimulation)

An image of the pulse generator (approved for use in pain management / spinal cord stimulation)

Press release issued: 9 May 2012

Researchers from the University’s School of Physiology and Pharmacology were part of the first UK team and the third in the world to successfully implant a nerve-stimulating device in two patients with heart failure.

Researchers from the University’s School of Physiology and Pharmacology were part of the first UK team and the third in the world to successfully implant a nerve-stimulating device in two patients with heart failure.

Professor Julian Paton and Dr Emma Hart were both part of a team led by Dr Angus Nightingale, consultant cardiologist from the Bristol Heart Institute, that carried out the first European trial to pilot the device to help reverse the effects of the disease.

Many patients with heart failure have enlarged hearts, which occurs as the heart loses its ability to pump and leads to tiredness and breathlessness. The theory behind the device is that by protecting the heart from the effects of adrenaline, which causes the heart to work faster and enlarge, it will begin to shrink and pump more efficiently.

The device, which is similar to a pacemaker, is fitted under the patient’s skin in the chest and attached to the vagus nerve that leads to both the heart and brain. It is an approach that is being used to treat depression and epilepsy currently but may have other beneficial effects. Once activated the device uses electrical pulses to stimulate the nerve to help improve cardiac function and life expectancy.

The vagus nerve is part of the autonomic nervous system, which controls functions of the body that are not under voluntary control, such as heart rate. It passes through the neck as it travels between the chest, abdomen and the lower part of the brain.

The trial sponsored by Boston Scientific Corporation involves 96 patients at 25 sites across Europe. The Bristol team are co-ordinating the trial across the UK, which is expected to finish in 2013. The trial is called: NECTAR-HF (Neural Cardiac Therapy for Heart Failure) and is an international clinical study which will examine whether vagal nerve stimulation can restore autonomic balance and therefore improve heart function and inhibit progression of heart failure.

Julian Paton said: “More than a million adults in the UK suffer from heart failure, this new treatment has to date shown promising results in both animals and humans and could offer new hope in improving both the quality and longevity of life for UK patients. We have no idea how it works but are planning a sub-study to work this out.”

Angus Nightingale added: “It is really exciting that Bristol is at the cutting edge of new research into heart failure. This is a great example of research where collaboration between clinicians and scientists in Bristol is making a difference to patients with heart problems. We are the first team to implant a vagal nerve stimulator into a patient in the UK. The idea behind this is that chronic autonomic imbalance is believed to be a risk factor of the progression of heart failure and adverse cardiovascular events. The stimulation should alter the balance of the system and improve cardiac function."