More than 150 years ago, vagus nerve stimulation was tried out for the first time in an experimental setting. In the 1980’s and 1990’s, vagus nerve stimulation was demonstrated to have significant antiarrhythmic effects in both conscious and anaesthetized animals, especially during acute myocardial ischemia. Chronic Heart Failure (CHF) is characterized by autonomic dysregulation, which is marked by a persistent rise in sympathetic drive and a decline in parasympathetic activity. Poor long-term outcomes in HF patients are predicted by sympathetic overdrive and elevated heart rate. The widespread use of selective and non-selective betaadrenergic receptor blockers is the classic example of pharmacologic medicines that partially reduce sympathetic activity being used as an effective long-term therapy for patients with HF. In contrast, despite its complicated cardiovascular effects, modulating parasympathetic activity as a potential treatment for HF has gotten little study over the years. In this article, we examine the outcomes of recent experimental animal experiments that suggest the potential use of electrical Vagus Nerve Stimulation (VNS) as a long-term therapy for the management of chronic Heart Failure (HF). The review will examine the effects of chronic VNS on Left Ventricular (LV) function as well as the impact of VNS on cytokine production and nitric oxide generation as potential modifiers of the HF state. Finally, we will briefly examine several nerve stimulation techniques that are also being researched as prospective therapeutic methods for the management of chronic HF.
