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How BAROSTIM THERAPY™ is Designed to Work

The mechanism of action

The human body has its own physiologic mechanisms for sensing changes in blood pressure and other blood flow changes. This natural system is largely located in the brain, as well as in the walls of the carotid arteries, which are the vessels in the neck that supply blood to the brain. Pressure sensors, called baroreceptors, are found on the carotid artery and in the carotid sinus. These sensors measure and report blood flow to the brain, which compares it to the body's needs.  

BAROSTIM THERAPY™ is a neuromodulation therapy that activates the baroreceptors. By doing this, BAROSTIM THERAPY™ triggers the body's main cardiovascular reflex, thereby addressing the underlying causes of the progression of heart failure. 1

By activating the baroreceptors in the wall of the carotid artery, BAROSTIM NEO™ is able to stimulate the afferent and efferent pathways of the autonomic nervous system. The brain responds to BAROSTIM THERAPY™ by modulating efferent pathways, which relaxes the blood vessels, slows the heart rate and reduces fluid in the body via improved kidney function. BAROSTIM THERAPY™ also works to reduce the load on the heart by decreasing arterial resistance, thereby improving the heart's ability to pump blood to the tissues. The increase in parasympathetic tone and decrease in sympathetic drive results in the restoration of autonomic balance, which can improve cardiac structure and function.

BAROSTIM THERAPY™ is the only treatment with the potential to reduce sympathetic activity while restoring parasympathetic activity. 2,3,4

References: 
1. Gronda E et al. Baroreflex Activation Therapy: A New Approach to the Management of Advanced Heart Failure with Reduced Ejection Fraction" 2016 (In submission) 2. Abraham WT et al. Baroreflex Activation Therapy for the Treatment of Heart Failure With a Reduced Ejection Fraction. JACC Heart Fail. 2015 Jun;3(6):487-96. 3. Zile MR et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction: safety and efficacy in patients with and without cardiacresynchronization therapy. Eur J Heart Fail. 2015 Oct;17(10):1066-74. 4. BAROSTIM NEO™ system reference guide. Available at here – Last accessed March 2016

Demonstrated mechanism of action

BAROSTIM THERAPY™ elicits effect on muscle sympathetic nerve activity and heart rate. Muscle sympathetic nerve activity (MSNA) falls as BAROSTIM THERAPY™ is titrated.3

Demonstration of Peripheral Improvement:

Demonstration of Peripheral Improvement

Normalisation of cardiac autonomic tone is reflected in improved heart rate variability, as shown after 3 months of BAROSTIM THERAPY™:4

sympathetic activity Parasympathetic activity
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