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Erschienen in: Wiener Medizinische Wochenschrift 23-24/2014

01.12.2014 | main topic

Electrical carotid baroreceptor stimulation

verfasst von: Prof. Dr. med. Jürg Schmidli, Dr. med. Regula S. von Allmen, MD, Prof. Dr. Markus G. Mohaupt

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 23-24/2014

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Summary

The Barostim neoTM system is a novel implantable device that activates the carotid baroreflex. It decreases the sympathetic activity and inhibits the renin system, which results in reduced blood pressure and heart rate. In patients with resistant hypertension, electrically activation of the baroreflex leads to an average decrease in systolic blood pressure of 38, 36, 40 and 53 mmHg at 1, 2, 3 and 4 years, respectively. Additionally, cardiac remodelling with reduced left ventricular mass and posterior wall thickness has been observed in long-term studies. In a limited number of patients with heart failure, baroreflex activation therapy leads to a decrease in muscle sympathetic nerve activity and to improved quality of life and functional capacities. The implantation procedure is safe and associated with risks comparable with those of other active implantable devices. Barostim neo is currently available in several European countries.
Literatur
1.
Zurück zum Zitat Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.PubMedCrossRef Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.PubMedCrossRef
2.
Zurück zum Zitat Fields LE, Burt VL, Cutler JA, et al. The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 2004;44(4):398–404.PubMedCrossRef Fields LE, Burt VL, Cutler JA, et al. The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 2004;44(4):398–404.PubMedCrossRef
3.
Zurück zum Zitat Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 2003;290(2):199–206.PubMedCrossRef Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 2003;290(2):199–206.PubMedCrossRef
4.
5.
Zurück zum Zitat Wienemann H, Meincke F, Kaiser L, et al. Treating resistant hypertension with new devices. Minerva Cardioangiol. 2014;62(3):235–41.PubMed Wienemann H, Meincke F, Kaiser L, et al. Treating resistant hypertension with new devices. Minerva Cardioangiol. 2014;62(3):235–41.PubMed
6.
Zurück zum Zitat Brest AN, Wiener L, Bachrach B. Bilateral carotid sinus nerve stimulation in the treatment of hypertension. Am J Cardiol. 1972;29(6):821–5.PubMedCrossRef Brest AN, Wiener L, Bachrach B. Bilateral carotid sinus nerve stimulation in the treatment of hypertension. Am J Cardiol. 1972;29(6):821–5.PubMedCrossRef
7.
Zurück zum Zitat Koch E. Die reflektorische Selbststeuerung des Kreislaufs. In B. Kisch, Editor. Dresden-Leipzig: Th. Steinkopff 1931 Koch E. Die reflektorische Selbststeuerung des Kreislaufs. In B. Kisch, Editor. Dresden-Leipzig: Th. Steinkopff 1931
8.
Zurück zum Zitat Muratori G. Histological observations on the structure of the carotid sinus in man and mammals. In: Kezdi P, editor. Baroreceptors and hypertension. Oxford: Pergamon; 1967. 253–65 p. Muratori G. Histological observations on the structure of the carotid sinus in man and mammals. In: Kezdi P, editor. Baroreceptors and hypertension. Oxford: Pergamon; 1967. 253–65 p.
9.
Zurück zum Zitat Peters TK, Koralewski HE, Zerbst E. Blood pressure and heart rate changes during physical activity upon heart rate feedback-controlled electrical carotid sinus nerve stimulation. Int J Cardiol. 1989;22(3):389–92.PubMedCrossRef Peters TK, Koralewski HE, Zerbst E. Blood pressure and heart rate changes during physical activity upon heart rate feedback-controlled electrical carotid sinus nerve stimulation. Int J Cardiol. 1989;22(3):389–92.PubMedCrossRef
10.
Zurück zum Zitat Lohmeier TE, Irwin ED, Rossing MA, et al. Prolonged activation of the baroreflex produces sustained hypotension. Hypertension. 2004;43(2):306–11.PubMedCrossRef Lohmeier TE, Irwin ED, Rossing MA, et al. Prolonged activation of the baroreflex produces sustained hypotension. Hypertension. 2004;43(2):306–11.PubMedCrossRef
11.
Zurück zum Zitat Scheffers I, Schmidli J, Kroon A, et al. Sustained blood pressure reduction by baroreflex hypertension therapy with a chronically implanted system: 3-year data from the Rheos DEBuT study in patients with resistant hypertension. J Hypertens. 2009;27:S421. Scheffers I, Schmidli J, Kroon A, et al. Sustained blood pressure reduction by baroreflex hypertension therapy with a chronically implanted system: 3-year data from the Rheos DEBuT study in patients with resistant hypertension. J Hypertens. 2009;27:S421.
12.
Zurück zum Zitat Tordoir JH, Scheffers I, Schmidli J, et al. An implantable carotid sinus baroreflex activating system: surgical technique and short-term outcome from a multi-center feasibility trial for the treatment of resistant hypertension. Eur J Vasc Endovasc Surg. 2007;33(4):414–21.PubMedCrossRef Tordoir JH, Scheffers I, Schmidli J, et al. An implantable carotid sinus baroreflex activating system: surgical technique and short-term outcome from a multi-center feasibility trial for the treatment of resistant hypertension. Eur J Vasc Endovasc Surg. 2007;33(4):414–21.PubMedCrossRef
13.
Zurück zum Zitat Schmidli J, Savolainen H, Eckstein F, et al. Acute device-based blood pressure reduction: electrical activation of the carotid baroreflex in patients undergoing elective carotid surgery. Vascular. 2007;15(2):63–9.PubMedCrossRef Schmidli J, Savolainen H, Eckstein F, et al. Acute device-based blood pressure reduction: electrical activation of the carotid baroreflex in patients undergoing elective carotid surgery. Vascular. 2007;15(2):63–9.PubMedCrossRef
14.
Zurück zum Zitat Scheffers IJ, Kroon AA, Schmidli J, et al. Novel baroreflex activation therapy in resistant hypertension: results of a European multi-center feasibility study. J Am Coll Cardiol. 2010;56(15):1254–8.PubMedCrossRef Scheffers IJ, Kroon AA, Schmidli J, et al. Novel baroreflex activation therapy in resistant hypertension: results of a European multi-center feasibility study. J Am Coll Cardiol. 2010;56(15):1254–8.PubMedCrossRef
15.
Zurück zum Zitat Bisognano JD, Bakris G, Nadim MK, et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J Am Coll Cardiol. 2011;58(7):765–73.PubMedCrossRef Bisognano JD, Bakris G, Nadim MK, et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J Am Coll Cardiol. 2011;58(7):765–73.PubMedCrossRef
16.
Zurück zum Zitat Bakris GL, Nadim MK, Haller H, et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the Rheos Pivotal Trial. J Am Soc Hypertens. 2012;6(2):152–8.PubMedCrossRef Bakris GL, Nadim MK, Haller H, et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the Rheos Pivotal Trial. J Am Soc Hypertens. 2012;6(2):152–8.PubMedCrossRef
17.
Zurück zum Zitat Alnima T, de Leeuw PW, Tan FE, et al. Renal responses to long-term carotid baroreflex activation therapy in patients with drug-resistant hypertension. Hypertension. 2013;61(6):1334–9.PubMedCrossRef Alnima T, de Leeuw PW, Tan FE, et al. Renal responses to long-term carotid baroreflex activation therapy in patients with drug-resistant hypertension. Hypertension. 2013;61(6):1334–9.PubMedCrossRef
18.
Zurück zum Zitat Wustmann K, Kucera JP, Scheffers I, et al. Effects of chronic baroreceptor stimulation on the autonomic cardiovascular regulation in patients with drug-resistant arterial hypertension. Hypertension. 2009;54(3):530–6.PubMedCrossRef Wustmann K, Kucera JP, Scheffers I, et al. Effects of chronic baroreceptor stimulation on the autonomic cardiovascular regulation in patients with drug-resistant arterial hypertension. Hypertension. 2009;54(3):530–6.PubMedCrossRef
19.
Zurück zum Zitat Bisognano JD, Kaufman CL, Bach DS, et al. Improved cardiac structure and function with chronic treatment using an implantable device in resistant hypertension: results from European and United States trials of the Rheos system. J Am Coll Cardiol. 2011;57(17):1787–8.PubMedCrossRef Bisognano JD, Kaufman CL, Bach DS, et al. Improved cardiac structure and function with chronic treatment using an implantable device in resistant hypertension: results from European and United States trials of the Rheos system. J Am Coll Cardiol. 2011;57(17):1787–8.PubMedCrossRef
20.
Zurück zum Zitat Mohaupt MG, Schmidli J, Luft FC. Management of uncontrollable hypertension with a carotid sinus stimulation device. Hypertension. 2007;50(5):825–8.PubMedCrossRef Mohaupt MG, Schmidli J, Luft FC. Management of uncontrollable hypertension with a carotid sinus stimulation device. Hypertension. 2007;50(5):825–8.PubMedCrossRef
21.
Zurück zum Zitat Hoppe UC, Brandt MC, Wachter R, et al. Minimally invasive system for baroreflex activation therapy chronically lowers blood pressure with pacemaker-like safety profile: results from the Barostim neo trial. J Am Soc Hypertens. 2012;6(4):270–6.PubMedCrossRef Hoppe UC, Brandt MC, Wachter R, et al. Minimally invasive system for baroreflex activation therapy chronically lowers blood pressure with pacemaker-like safety profile: results from the Barostim neo trial. J Am Soc Hypertens. 2012;6(4):270–6.PubMedCrossRef
22.
Zurück zum Zitat Alnima T, Scheffers I, De Leeuw PW, et al. Sustained acute voltage-dependent blood pressure decrease with prolonged carotid baroreflex activation in therapy-resistant hypertension. J Hypertens. 2012;30(8):1665–70.PubMedCrossRef Alnima T, Scheffers I, De Leeuw PW, et al. Sustained acute voltage-dependent blood pressure decrease with prolonged carotid baroreflex activation in therapy-resistant hypertension. J Hypertens. 2012;30(8):1665–70.PubMedCrossRef
23.
Zurück zum Zitat Task Force for the management of arterial hypertension of the European Society of H, Task Force for the management of arterial hypertension of the European Society of C. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Blood Press. 2013;22(4):193–278.CrossRef Task Force for the management of arterial hypertension of the European Society of H, Task Force for the management of arterial hypertension of the European Society of C. 2013 ESH/ESC Guidelines for the management of arterial hypertension. Blood Press. 2013;22(4):193–278.CrossRef
24.
Zurück zum Zitat Borisenko O, Beige J, Lovett EG, et al. Cost-effectiveness of Barostim therapy for the treatment of resistant hypertension in European settings. J Hypertens. 2014;32(3):681–92.PubMedCrossRef Borisenko O, Beige J, Lovett EG, et al. Cost-effectiveness of Barostim therapy for the treatment of resistant hypertension in European settings. J Hypertens. 2014;32(3):681–92.PubMedCrossRef
25.
Zurück zum Zitat Eichler HG, Kong SX, Gerth WC, et al. Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge? Value Health. 2004;7(5):518–28.PubMedCrossRef Eichler HG, Kong SX, Gerth WC, et al. Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge? Value Health. 2004;7(5):518–28.PubMedCrossRef
26.
Zurück zum Zitat Gronda E, Seravalle G, Brambilla G, et al. Chronic baroreflex activation effects on sympathetic nerve traffic, baroreflex function, and cardiac haemodynamics in heart failure: a proof-of-concept study. Eur J Heart Fail. 2014;16(9):977–83.PubMedCentralPubMedCrossRef Gronda E, Seravalle G, Brambilla G, et al. Chronic baroreflex activation effects on sympathetic nerve traffic, baroreflex function, and cardiac haemodynamics in heart failure: a proof-of-concept study. Eur J Heart Fail. 2014;16(9):977–83.PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Madershahian N, Scherner M, Muller-Ehmsen J, et al. Baroreflex activation therapy in patients with pre-existing implantable cardioverter-defibrillator: compatible, complementary therapies. Europace. 2014;16(6):861–5.PubMedCrossRef Madershahian N, Scherner M, Muller-Ehmsen J, et al. Baroreflex activation therapy in patients with pre-existing implantable cardioverter-defibrillator: compatible, complementary therapies. Europace. 2014;16(6):861–5.PubMedCrossRef
28.
Zurück zum Zitat Kroon AA, Schmidli J, Scheffers I, et al. Chronically implanted system: 4-year data of Rheos DEBuT-HT study in patients with resistant hypertension. J Hypertens. 2010;28(e-suppl. A):278. Kroon AA, Schmidli J, Scheffers I, et al. Chronically implanted system: 4-year data of Rheos DEBuT-HT study in patients with resistant hypertension. J Hypertens. 2010;28(e-suppl. A):278.
Metadaten
Titel
Electrical carotid baroreceptor stimulation
verfasst von
Prof. Dr. med. Jürg Schmidli
Dr. med. Regula S. von Allmen, MD
Prof. Dr. Markus G. Mohaupt
Publikationsdatum
01.12.2014
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 23-24/2014
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-014-0329-2

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