Table 1: Targets of Autonomic Therapies in Heart Failure within the Cardiac Neuraxis.
VNS | SCS | BAT | RDN | Stellate Ganglionectomy | |
---|---|---|---|---|---|
Targets | |||||
Activation of vagal efferents | Reduce afferent input | Activation of carotid sinus baroreceptor afferent fibres | Reduce renal afferent input | Reduce afferent input | |
Modulate intrathoracic cardiocardiac reflexes | Modulate spinal cord sympathetic reflexes (preganglionic) | Reduce central sympathetic outflow | Reduce renal efferent output | Interrupt preganglionic sympathetic outflow to heart | |
Activation of ascending afferents to modulate central reflexes | Blunt extracardiac sympathetic reflexes | Increase central parasympathetic outflow | Reduce central sympathetic outflow | Blunt extracardiac sympathetic reflexes | |
Render myocytes stress-resistant | Blunt intrinsic cardiac nervous system reflexes | Blunt intrinsic cardiac nervous system reflexes | |||
Render myocytes stress-resistant | Render myocytes stress-resistant |
BAT = baroreceptor activation therapy; RDN = renal denervation; SCS = spinal cord stimulation; VNS = vagus nerve stimulation.