Sympathovagal imbalance contributes to progressive worsening of heart failure and is associated with untoward clinical outcomes. Here we review the role of the autonomic nervous system in modulating the cardiovascular system, as well as the role of dysregulation of the autonomic nervous system in the pathogenesis of heart failure. We also discuss the experimental basis, rationale, and outcomes of ongoing clinical trials of using five different approaches to modulate the autonomic system in heart failure, including vagus nerve stimulation, spinal cord stimulation, renal denervation, baroreceptor activation therapy, and left cardiac sympathetic denervation. These approaches represent an exciting new era for the treatment of patients with heart failure.

Original languageEnglish
Title of host publicationCardioskeletal Myopathies in Children and Young Adults
PublisherElsevier Inc.
Number of pages11
ISBN (Print)9780128000403
StatePublished - Nov 15 2016


  • Clinical trial
  • Heart failure
  • Neruomodulation
  • Parasympathetic nervous system
  • Sympathetic nervous system
  • Sympathovagal imbalance


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