Baroreflex Neuromodulation
- The autonomic nervous system (ANS) is integral to cardiovascular system function
- Heart failure (HF) pathophysiology is mediated by autonomic dysfunction with a sustained imbalance of increased sympathetic activity and decreased parasympathetic activity
- The baroreflex, a key powerful regulator of cardiovascular homeostasis, is a critical consideration in heart failure
- Baroreflex neuromodulation has a role as an HF therapy
Baroreceptors and Baroreflex Mechanism
- The baroreflex provides a powerful centralized neuromodulation to ANS
- Maintains normal homeostasis: Inhibition of sympathetic activity and augmentation of parasympathetic drive
- Therapeutic target to restore natural physiological autonomic adaptation and balance
- Carotid baroreceptors are mechanoreceptors
- Located in carotid sinus (more sensitive than the aortic arch receptors)
- Activated by arterial wall stretch, not pressure
- Triggers increased signaling to the brain
- Sustained baroreceptor activation response to pulsatile carotid sinus stretch
