Baroreflex amplification by carotid sinus stimulation

Abstract

Cardiovascular diseases including arterial hypertension and congestive heart failure are often associated with an imbalance in cardiovascular autonomic control toward sympathetic predominance. Baroreflex activation could target the imbalance in cardiovascular autonomic control, and studies in the last years determined whether amplification of afferent carotid baroreflex signaling could be beneficial. Two different approaches have been developed to augment carotid baroreflex activation. Electrodes placed near the carotid sinus can electrically activate baroreceptors or baroreflex afferents. Another approach is placement of specialized vascular stents changing vascular geometry in the carotid sinus. Thus far, none of these treatments has been shown to reduce cardiovascular morbidity or mortality in sufficiently large controlled clinical trials.