Vagal stimulation for heart failure

Purpose of review On the very solid background of experimental and clinical studies pointing to the cardiovascular risks associated with depressed vagal reflexes and supported by specific experiments in animal models of heart failure, we are witnessing a rapidly growing interest in the very untraditional approach to the management of heart failure represented by chronic vagal stimulation. Recent findings Additional studies have been performed using vagal stimulation in animal models of heart failure showing that benefit can occur even in the absence of heart rate changes. The first in-man studies of chronic vagal stimulation have been performed, first as a single center and then as a small multicenter study with favorable results in terms of feasibility, safety, and efficacy. Summary The initial observations with chronic vagal stimulation in man, though limited by very small numbers, are very encouraging and seem to open new paths, or perhaps avenues, for the management of symptomatic heart failure. This transition between experimental and clinical approaches represents an exciting example of translational research.