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Pivotal trial shows HFrEF benefits from baroreceptor stimulation

Key clinical point: Baroreflex activation therapy improved quality of life and function, and lowered NT-proBNP levels in HFrEF patients ineligible for CRT.

Major finding: Minnesota Living With Heart Failure Questionnaire scores improved by an average of 14 points on BAT, compared with control patients.

Study details: BeAT-HF, a multicenter, randomized, pivotal trial with 264 HFrEF patients.

Disclosures: BeAT-HF was sponsored by CVRx, the company developing the baroreflex activation device. Dr. Zile has been a consultant to CVRx and to Abbott, AstraZeneca, Bayer, Bristol-Myers Squibb, Lilly, Merck, and Novartis.

Citation:

Zile MR et al. Abstract, S-LBCT01-04.

Commentary:

The results that Dr. Zile reported are obviously very promising. It was a huge step forward when researchers identified medical treatments that can safely manipulate the autonomic nervous system in patients with heart failure with reduced ejection fraction. Now we are asking what else we can do because we have run into limits on what we can accomplish with drugs alone. The BeAT-HF study is a step in that direction.

Over the past 20 years or so, electrophysiologists and heart failure physicians have worked together to develop implanted devices that can improve heart failure management. Despite this, many patients remain ineligible for existing devices. The evidence from BeAT-HF is a good start on documenting the benefit of a new option, and I’m encouraged that it’s on the right track, but I don’t think I’ll start using this device in patients this week.

Andrew D. Krahn, MD, is professor of medicine and head of cardiology at the University of British Columbia and St. Paul’s Hospital in Vancouver. He has been a consultant to Medtronic and he has received research funding from Boston Scientific and Medtronic. He made these comments as a discussant for BeAT-HF.