HFSA ePoster Library

Introduction: There are limited strategies addressing the reversible hypoperfusion and fluid retention observed in acute decompensated heart failure (ADHF). Aberrant autonomic reflex physiology is believed to contribute to clinical decompensation. Our previous work demonstrated catheter-based cardiopulmonary nerve stimulation (CPNS) can increase cardiac contractility.
Objective: The study objective was to evaluate short-term safety and feasibility of a novel CPNS System.
Methods: Subjects (n=18) undergoing a catheterization procedure or ICD/CRT implant were studied. After the index procedure, the investigational CPNS neuromodulation catheter was delivered to the right PA. Stimulus sequences were used to evoke cardiac responses. Changes in LV contractility (LV dP/dt max), LV relaxation (LV dP/dt min), arterial blood pressure, and heart rate were measured with and without stimulation over a period of 1-3 hours.
Results: No adverse events occurred over the course of the study. Fifteen (15) of the eighteen (18) subjects (83%) exhibited increased contractility with CPNS (stimulation time between 60 -120 seconds). The increase in LV contractility was substantial 60% [6, 173%]. LV relaxation 18% [-11, 70%], mean arterial pressure 13% [-1, 60%], arterial pulse pressure 26% [-3, 80%], and estimated stroke volume calculated from pulse pressure +13% [-12,70] also increased while HR was relatively unchanged 1% [-20, +13%].
Conclusions: CPNS to increase cardiac contractility is feasible and likely safe. Heart rate neutral changes in LV contractility, relaxation, and arterial blood pressure were reproducible over the short period of testing. Additional and longer-term studies are required to assess the impacts on clinical heart failure endpoints.