Evidence map›Paper›PMID 25176942›Full record

Trial reportEuropean heart journal2015

Chronic vagal stimulation for the treatment of low ejection fraction heart failure: results of the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) randomized controlled trial.

Faiez Zannad, Gaetano M De Ferrari, Anton E Tuinenburg, David Wright, Josep Brugada, Christian Butter, Helmut Klein, Craig Stolen, Scott Meyer, Kenneth M Stein and 10 more

2 registry-linked trialsOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 191 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
191citing papers in PubMed, 6 pooled it
24.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01385176 naactive not recruitingnot on this map

Neural Cardiac Therapy for Heart Failure Study

TypeinterventionalSponsorBoston Scientific CorporationRan2011 to 2027Enrolled118ConditionsHeart Failure, Congestive Heart FailureArmsImplant of investigational device system, Titration during the randomization phase, Titration after the randomization phase, Blood Draw
NCT07093034 nacompletednot on this mapstarted 2025, after this paper: background citation

Sustained Auricular Nerve Stimulation for PVC Suppression

TypeinterventionalSponsorUniversity of California, San DiegoRan2025 to 2026Enrolled16ConditionsPremature Ventricular Complexes, PVC - Premature Ventricular Contraction, Auricular Vagus Nerve StimulationArmsExtended nocturnal use of auricular vagus nerve stimulator device
3 · Its place in the literature

Who cites it

191 citing papers in PubMed, 6 syntheses or guidelines pooled it, 372 citations in OpenAlex.

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  12. Autonomic Neuromodulation Acutely Ameliorates Left Ventricular Strain in Humans.Journal of cardiovascular translational research · 2019
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  14. ANTHEM-HFrEF: does early termination obscure a potential treatment signal?Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
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131 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 13 institutions in 8 countries.

Faiez ZannadInserm, CIC 1433, Centre Hospitalier Universitaire, Department of Cardiology, Nancy University, Université de Lorraine, Nancy, France f.zannad@chu-nancy.fr.
Gaetano M De FerrariDepartment of Cardiology and Cardiovascular Clinical Research Center, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy.
Anton E TuinenburgDepartment of Cardiology, University Medical Center, Utrecht, The Netherlands.
David WrightDepartment of Cardiology, Liverpool Heart and Chest, Liverpool, UK.
Josep BrugadaThorax Institute, Hospital Clinic, Barcelona, Spain.
Christian ButterHeart Centre Brandenburg Hospital, Bernau, Germany.
Helmut KleinDivision of Cardiology, Otto-von-Guericke Universität Magdeburg, Magdeburg, Germany.
Craig StolenBoston Scientific Corporation, St. Paul, MN, USA.
Scott MeyerBoston Scientific Corporation, St. Paul, MN, USA.
Kenneth M SteinBoston Scientific Corporation, St. Paul, MN, USA.
Agnes RamuzatGuidant Europe, Diegem, Belgium.
Bernd SchubertGuidant Europe, Diegem, Belgium.
Doug DaumBoston Scientific Corporation, St. Paul, MN, USA.
Petr NeuzilDepartment of Cardiology, Homolka Hospital, Prague, Czech Republic.
Cornelis BotmanDepartment of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
Maria Angeles CastelThorax Institute, Hospital Clinic, Barcelona, Spain.
Antonio D'OnofrioAzienda Ospedaliera dei Colli - Monaldi, Napoli, Italy.
Scott D SolomonCardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Nicholas WoldBoston Scientific Corporation, St. Paul, MN, USA.
Stephen B RubleBoston Scientific Corporation, St. Paul, MN, USA.
Boston Scientific (Netherlands) · NLBoston Scientific (United States) · USHospital Clínic de Barcelona · ESDéfaillance Cardiovasculaire Aiguë et ChroniqueDeutsches Herzzentrum der Charité · DEHarvard University · USIstituti di Ricovero e Cura a Carattere Scientifico · ITLiverpool Heart and Chest Hospital · GBNa Homolce Hospital · CZOspedale Monaldi · ITOtto-von-Guericke University Magdeburg · DERadboud University Nijmegen · NLUniversity Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe neural cardiac therapy for heart failure (NECTAR-HF) was a randomized sham-controlled trial designed to evaluate whether a single dose of vagal nerve stimulation (VNS) would attenuate cardiac remodelling, improve cardiac function and increase exercise capacity in symptomatic heart failure patients with severe left ventricular (LV) systolic dysfunction despite guideline recommended medical therapy.

methodsPatients were randomized in a 2 : 1 ratio to receive therapy (VNS ON) or control (VNS OFF) for a 6-month period. The primary endpoint was the change in LV end systolic diameter (LVESD) at 6 months for control vs. therapy, with secondary endpoints of other echocardiography measurements, exercise capacity, quality-of-life assessments, 24-h Holter, and circulating biomarkers.

resultsOf the 96 implanted patients, 87 had paired datasets for the primary endpoint. Change in LVESD from baseline to 6 months was -0.04 ± 0.25 cm in the therapy group compared with -0.08 ± 0.32 cm in the control group (P = 0.60). Additional echocardiographic parameters of LV end diastolic dimension, LV end systolic volume, left ventricular end diastolic volume, LV ejection fraction, peak V02, and N-terminal pro-hormone brain natriuretic peptide failed to show superiority compared to the control group. However, there were statistically significant improvements in quality of life for the Minnesota Living with Heart Failure Questionnaire (P = 0.049), New York Heart Association class (P = 0.032), and the SF-36 Physical Component (P = 0.016) in the therapy group.

conclusionVagal nerve stimulation as delivered in the NECTAR-HF trial failed to demonstrate a significant effect on primary and secondary endpoint measures of cardiac remodelling and functional capacity in symptomatic heart failure patients, but quality-of-life measures showed significant improvement.

Indexed as

Electrocardiography, AmbulatoryExercise ToleranceFemaleHeart FailureHumansMaleMiddle AgedPatient SafetyQuality of LifeTreatment OutcomeVagus Nerve StimulationVentricular Dysfunction, LeftVentricular RemodelingAutonomic nervous systemHeart failureVagal stimulation

Identifiers

PMID25176942
PMCPMC4328197
OpenAlexW2109454934

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.