Article thumbnail

Electrical modalities beyond pacing for the treatment of heart failure

By Richard N. Cornelussen, Vincent Splett, Ruth Nicholson Klepfer, Berthold Stegemann, Lilian Kornet and Frits W. Prinzen


In this review, we report on electrical modalities, which do not fit the definition of pacemaker, but increase cardiac performance either by direct application to the heart (e.g., post-extrasystolic potentiation or non-excitatory stimulation) or indirectly through activation of the nervous system (e.g., vagal or sympathetic activation). The physiological background of the possible mechanisms of these electrical modalities and their potential application to treat heart failure are discussed

Topics: Article
Publisher: Springer US
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (1990). A new pacing method for rapid regularization and rate control in atrial fibrillation.
  2. (2008). A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation in patients with systolic heart failure: rationale, design, and baseline patient characteristics.
  3. (2005). Abnormal cardiac wall motion and early matrix metalloproteinase activity.
  4. (2001). Acute ventricular reduction with the acorn cardiac support device: effect on progressive left ventricular dysfunction and dilation in dogs with chronic heart failure.
  5. (2000). Beta-blocker therapy for heart failure: the evidence is in now the work begins.
  6. (2002). Cardiac contractility modulation by electric currents applied during the refractory period.
  7. (2006). Cardiac contractility modulation by non-excitatory currents: studies in isolated cardiac muscle.
  8. (2008). Cardiac contractility modulation electrical signals improve myocardial gene expression in patients with heart failure.
  9. (2009). Cardiac contractility modulation electrical signals normalize activity, expression, and phosphorylation of the Na ? -Ca2 ? exchanger in heart failure.
  10. (2008). Cardiac contractility modulation in non-responders to cardiac resynchronization therapy.
  11. (2000). Chronic unloading by left ventricular assist device reverses contractile dysfunction and alters gene expression in end-stage heart failure.
  12. (2009). Chronic vagal stimulation in patients with congestive heart failure.
  13. (2009). Chronic vagus nerve stimulation improves autonomic control and attenuates systemic inflammation and heart failure progression in a canine high-rate pacing model.
  14. (1964). Clinical observations on paired electrical stimulation of the heart. Effects on ventricular performance and heart rate.
  15. (2009). Clinical trials update from the American College of Cardiology
  16. (1999). Continuous intravenous dobutamine is associated with an increased risk of death in patients with advanced heart failure: insights from the Flolan International Randomized Survival Trial (FIRST).
  17. (2008). Contractility augmentation induced by refractory period stimulation depends upon pacing-site and diminishes over time. Circulation 118:S726
  18. (1998). Control of negative inotropic vagal preganglionic neurons in the dog: synaptic interactions with substance P afferent terminals in the nucleus ambiguus?
  19. (1991). Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE study research group.
  20. (2010). Effect of peri-infarct pacing early after myocardial infarction: results of the prevention of myocardial enlargement and dilatation post myocardial infarction study.
  21. (2008). Effects of chronic therapy with cardiac contractility modulation electrical signals on cytoskeletal proteins and matrix metalloproteinases in dogs with heart failure.
  22. (2010). Effects of electric stimulations applied during absolute refractory period on cardiac function of rabbits with heart failure.
  23. (2003). Electric currents applied during refractory period enhance contractility and systolic calcium in the ferret heart.
  24. (2007). Enhanced inotropic state of the failing left ventricle by cardiac contractility modulation electrical signals is not associated with increased myocardial oxygen consumption.
  25. et al (2006) Paired ventricular stimulation: an approach for hemodynamic stabilization during ventricular tachycardia.
  26. et al (2010) Augmentation of left ventricular contractility by cardiac sympathetic neural stimulation.
  27. et al (2010) Early short-term vagal nerve stimulation attenuates cardiac remodeling after reperfused myocardial infarction.
  28. (2007). Feasibility of biventricular pacing in patients with recent myocardial infarction: impact on ventricular remodeling.
  29. (1966). Field stimulation as a means of effecting the graded release of autonomic transmitters in isolated heart muscle.
  30. (2004). First human chronic experience with cardiac contractility modulation by nonexcitatory electrical currents for treating systolic heart failure: mid-term safety and efficacy results from a multicenter study.
  31. (2001). Focal atrial fibrillation: experimental evidence for a pathophysiologic role of the autonomic nervous system.
  32. (2009). Impact of cardiac contractility modulation on left ventricular global and regional function and remodeling.
  33. (1960). Inotropic effects of trains of impulses applied during the contraction of cardiac muscle.
  34. (2004). Long-term effects of non-excitatory cardiac contractility modulation electric signals on the progression of heart failure in dogs.
  35. (2010). Long-term localized high-frequency electric stimulation within the myocardial infarct: effects on matrix metalloproteinases and regional remodeling.
  36. (2005). Long-term therapy with neuroselectiveelectric vagus nerve stimulation improves LV function and attenuates global LV remodeling in dogs with chronic heart failure.
  37. (1999). Mapping of regional myocardial strain and work during ventricular pacing: experimental study using magnetic resonance imaging tagging.
  38. (2006). Mode of action of spinal cord stimulation in neuropathic pain.
  39. (2009). Multicenter randomized controlled trial of cardiac contractility modulation in patient with advanced heart failure. In: American College of Cardiology Orlando,
  40. (2007). Myocardial matrix remodeling and the matrix metalloproteinases: influence on cardiac form and function.
  41. (1973). Noninvasive technique for detection of electrical activity during the P-R segment.
  42. (2005). Normalization of right ventricular performance and remodeling evaluated by magnetic resonance imaging at late follow-up of heart transplantation: relationship between function, exercise capacity and pulmonary vascular resistance.
  43. (1966). Paired electrical stimulation. A comparison of the effects on performance of the failing and nonfailing heart.
  44. (1969). Paired pacing after coronary artery ligation.
  45. (2009). Peri-infarct pacing with CRT in the early postinfarct phase to attenuate long-term remodeling.
  46. (1990). Post-extrasystolic potentiation without a compensatory pause in normal and diseased hearts.
  47. (1993). Postextrasystolic potentiation. Do we really know what it means and how to use it?
  48. (2008). Prevention of adverse electrical and mechanical remodeling with biventricular pacing in a rabbit model of myocardial infarction.
  49. (1992). Prolonged supramaximal stimulation of canine efferent sympathetic neurons induces desensitization of inotropic responses without a change in myocardial beta-adrenergic receptors.
  50. (2008). Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: a review of experimental studies.
  51. (2008). Randomized, double blind study of non-excitatory, cardiac contractility modulation electrical impulses for symptomatic heart failure.
  52. (1990). Relation between steady-state force and intracellular
  53. (1980). Release of autonomic neuromediators by local ventricular electrical stimulation.
  54. (2005). Selective increase of cardiac neuronal sympathetic tone: a catheter-based access to modulate left ventricular contractility.
  55. (2006). Sensory fibers containing vanilloid receptor-1 (VR-1) mediate spinal cord stimulation-induced vasodilation.
  56. Short-term disruption in regional left ventricular electrical conduction patterns increases interstitial matrix metalloproteinase activity.
  57. (2009). Spinal cord stimulation improves ventricular function and reduces ventricular arrhythmias in a canine postinfarction heart failure model. Circulation 120(4):286–294 Heart Fail Rev
  58. (1996). Spinal cord stimulation in severe angina pectoris–presentation of current studies indications and clinical experience.
  59. (1994). Spinal electrical stimulation for intractable angina–long-term clinical outcome and safety.
  60. (1965). Studies on coupled pacing technique and some comments on paired electrical stimulation.
  61. (1984). Sympathetic nervous system activation in postextrasystolic potentiation: role of catecholamine release in enhancement of ventricular function.
  62. (2008). The acute hemodynamic response to dual chamber coupled pacing in heart failure patients.
  63. (2008). The effect of electrical fields on gene and protein expression in human osteoarthritic cartilage explants.
  64. (2007). Therapy with cardiac contractility modulation electrical signals improves left ventricular function and remodeling in dogs with chronic heart failure.
  65. (1997). Vagal control of left ventricular contractility is selectively mediated by a cranioventricular intracardiac ganglion in the cat.
  66. (2004). Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats.
  67. (1997). Vagal stimulation decreases left ventricular contractility mainly through negative chronotropic effect.
  68. (2001). Vagus nerve stimulation decreases left ventricular contractility in vivo in the human and pig heart.
  69. (1968). Ventricular coupled pacing in myocardial infarction with severe cardiocirculatory insufficiency. In: Cranefield P, Hoffman B (eds) Paired Pulse Stimulation of the Heart.
  70. (2007). Ventricular preexcitation modulates strain and attenuates cardiac remodeling in a swine model of myocardial infarction. Circulation 116(10):1162–1169 324 Heart Fail Rev
  71. (2007). Ventricular unloading tissue angiotensin II, matrix modulation, and function during left ventricular assist device support.