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Autonomic Regulation Therapy in Heart Failure

  • Pathophysiology of Myocardial Failure (I Anand and M Patarroyo-Aponte, Section Editors)
  • Published:
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Abstract

Autonomic regulation therapy (ART) is a rapidly emerging therapy in the management of congestive heart failure secondary to systolic dysfunction. Modulation of the cardiac neuronal hierarchy can be achieved with bioelectronics modulation of the spinal cord, cervical vagus, baroreceptor, or renal nerve ablation. This review will discuss relevant preclinical and clinical research in ART for systolic heart failure. Understanding mechanistically what is being stimulated within the autonomic nervous system by such device-based therapy and how the system reacts to such stimuli is essential for optimizing stimulation parameters and for the future development of effective ART.

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Conflict of Interest

Jeffrey L. Ardell serves as a scientific advisor to Cyberonics, Inc. Kalyanam Shivkumar and Una Buckley declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of UCLA and the National Institutes of Health and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

All procedures performed in studies involving animals were in accordance with the ethical standards of the East Tennessee State University and the University of California Los Angeles.

Sources of Funding

This work was supported by the Heart, Lung and Blood Institute grants HL71830 (JLA) and HL84261 (KS) and by a private sector funding for studies related to neuromodulation provided in part by St. Jude Medical (JLA) and Cyberonics Inc (JLA).

Author Contributions

All authors contributed equally to researching data for this article, writing the manuscript, discussing of content, and approving the final version before submission.

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Authors and Affiliations

  1. Cardiac Arrhythmia Center & Neurocardiology Research Center of Excellence, UCLA David Geffen School of Medicine, 100 Medical Plaza, Suite 660, Los Angeles, CA, 90095, USA

    Una Buckley, Kalyanam Shivkumar & Jeffrey L. Ardell

  2. Department of Medicine (Cardiology), UCLA Health System, 47-126 CHS, Los Angeles, CA, 90095, USA

    Jeffrey L. Ardell

  3. Interventional Cardiovascular Programs, UCLA Health System, Los Angeles, CA, 90095, USA

    Kalyanam Shivkumar

  4. UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, CA, 90095, USA

    Una Buckley

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  1. Una Buckley
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  2. Kalyanam Shivkumar
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  3. Jeffrey L. Ardell
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Correspondence to Jeffrey L. Ardell.

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This article is part of the Topical Collection on Pathophysiology of Myocardial Failure

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Buckley, U., Shivkumar, K. & Ardell, J.L. Autonomic Regulation Therapy in Heart Failure. Curr Heart Fail Rep 12, 284–293 (2015). https://doi.org/10.1007/s11897-015-0263-7

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