AgeTech World sat down with Nadim Yared, CEO of CVRx, to explore how the brain can play a major part in treating heart failures.
In the UK, heart failure affects about 900,000 people with 60,000 new cases annually and is predominantly a disease of older people, according to NHS England.
Heart failure is condition that affects the patient long-term and that, for most people, can’t be cured. In addition to healthy lifestyle changes, some patients affected by heart failure need to have a procedure to implant a small device in their chest that can help control their heart’s rhythm.
The most commonly used devices are implantable cardioverter defibrillators (ICDs), pacemakers, cardiac resynchronisation therapy devices (CRT) and CRT-Ds. The way the majority of these implants work is through electric shocks directly given to the heart.
On the other hand, Barostim gives patients a new heart failure treatment option. Barostim Baroreflex Activation Therapy (BAT) works by electrically stimulating carotid baroreceptors and, in return, the baroreflex.
Carotid baroreceptors detect the blood pressure in the carotid artery, which supplies blood to the brain. The nerve terminals of carotid baroreceptors are located bilaterally at the carotid artery bifurcation, close to the internal carotid artery.
The baroreflex is a body natural reflex that is responsible for the maintenance of arterial blood pressure.
Once electricity stimulate the carotid baroreceptors, the autonomic nervous system is triggered to regulate heart, kidney and vascular function through both sympathetic and parasympathetic pathways.
The parasympathetic nervous system controls the body at rest and it is responsible for the body’s “rest and digest” functions while the sympathetic nervous system controls the body’s responses to a perceived threat.
Yared says: “Many decades ago people discovered that by massaging the carotid artery, you could lower the blood pressure in the body. Actually, documents dated about 150 years ago from the Fiji Islands, show that this was a technique used to induce sleep, particularly with patients with a fever”.
Barostim transformed this into an implantable device that triggers the electrical mechanism all the time.
Yared explains that in heart failure patients the heart beats as fast as when doing intense physical activity. With more blood pumped, the heart gets bigger and bigger, and the walls of the organ come thinner.
To counteract this mechanism, Barostim “reduces the sympathetic tone and increase the parasympathetic tone,” says Yard.
In heart failure patients, the sympathetic tone is almost always too high and the parasympathetic tone is not high enough. This imbalance feels like if the patients is “working out 24 hours a day”.
This technology strength is that the therapy is not based on the heart. “We put a wire outside the carotid artery and we connect this wire to our pulse generator,” says Yared. “There is no wire or part of our device that goes inside the bloodstream or inside the heart. It is not invasive.”
The Barostim therapy aims to put the responsibility back in the hand of healthcare providers. “One of the main issues we have with heart failure patients is that they are rarely compliant,” says Yared. “The beauty of our device is that it shifts the responsibility to the doctor and the patient doesn’t have to do anything.
“We ask the patient to come back every six months to have the device checked and every five years the battery needs to be replaced.”
In Europe, Barostim has received the approval for the treatment of resistant high blood pressure and for the treatment of heart failure.
On the other hand, the company has an approval for the treatment of heart failure in the US.
“The governments should provide more access to technology,” says Yared. “It took CVRx almost 20 years to get the device approved with a lot trials, data collected and experimentations involved.
“It required a lot of development and a lot of money. We invested around $400 million before we did our IPO. Our plan now with the money we raised at the IPO is to go all the way towards profitability.”
