Condition · Evidence Hub
Vagus Nerve Stimulation for Heart Failure
Does vagus nerve stimulation help with heart failure? 21 human studies have investigated VNS for heart failure, including 5 systematic reviews, 8 RCTs, and 4 controlled trials, published between 2014 and 2026, with 10 published since 2022. Studies use implanted (iVNS), transcutaneous auricular (taVNS), and transcutaneous cervical (tcVNS) stimulation. Findings vary by study design and population; the studies below are ranked by evidence strength so you can weigh the research directly.
5 systematic reviews · 8 RCTs · 4 controlled trials · 4 observational studies
Evidence by Tier
strongest → weakest
- 5Systematic reviews & meta-analyses
- 8Randomised controlled trials
- 4Controlled clinical trials
- 4Observational & cohort studies
Stimulation Method
- 16iVNS
- 4taVNS
- 1tcVNS
Research Momentum
10 of 21 studies (48%) published since 2022 — an actively growing evidence base.
The studies
21 studies · strongest evidence firstNetwork meta-analysis on efficacy of nerve stimulation or modulation in patients with heart failure
Tseng et al. · Heart rhythm · 2026
systematic reviewsiVNSComplications of Implanted Vagus Nerve Stimulation: A Systematic Review and Meta-Analysis
Kalagara et al. · Cerebrovascular diseases (Basel, Switzerland) · 2025 · n = 474
systematic reviewsiVNSThe efficacy of transcutaneous vagus nerve stimulation in heart failure management - a systematic review and meta-analysis
Sun et al. · BMC cardiovascular disorders · 2025 · n = 374
systematic reviewstaVNSNon-pharmacologic autonomic neuromodulation for treatment of heart failure: A systematic review and meta-analysis of randomized controlled trials
Ahmed et al. · Trends in cardiovascular medicine · 2024 · n = 1,037
systematic reviewsiVNSVagal Neuromodulation in Chronic Heart Failure With Reduced Ejection Fraction: A Systematic Review and Meta-Analysis
Sant'Anna et al. · Frontiers in Cardiovascular Medicine · 2021
systematic reviewsiVNSVagal Nerve Stimulation in Patients With Heart Failure and Reduced Ejection Fraction: The ANTHEM-HFrEF Trial
Konstam et al. · Journal of the American College of Cardiology · 2026 · n = 532
RCTsiVNSBlood Pressure Variability After Non-invasive Low-level Tragus Stimulation in Acute Heart Failure
Nagai et al. · Journal of cardiovascular translational research · 2024 · n = 22
RCTstcVNSEffectiveness of transcutaneous vagus nerve stimulation for the treatment of tinnitus: an interventional prospective controlled study
Raj-Koziak et al. · International journal of audiology · 2024
RCTstaVNSNeuromodulation of Inflammation to Treat Heart Failure With Preserved Ejection Fraction: A Pilot Randomized Clinical Trial
Stavrakis et al. · Journal of the American Heart Association · 2022 · n = 26
RCTstaVNSAutonomic Modulation of Cardiac Arrhythmias: Methods to Assess Treatment and Outcomes
Stavrakis et al. · JACC. Clinical electrophysiology · 2020
RCTsiVNSVagus Nerve Stimulation for the Treatment of Heart Failure: The INOVATE-HF Trial
Gold et al. · Journal of the American College of Cardiology · 2016 · n = 707
RCTsiVNSChronic cyclic vagus nerve stimulation has beneficial electrophysiological effects on healthy hearts in the absence of autonomic imbalance
Lee et al. · Physiological reports · 2016
RCTsiVNSChronic 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
Zannad et al. · European Heart Journal · 2015 · n = 96
RCTsiVNSClinical outcome of electrical transcutaneous auricular vagal stimulation in patients with stable symptomatic chronic heart failure - A pilot study
Schukro et al. · Complementary therapies in medicine · 2025 · n = 12
controlled trialstaVNSAutonomic regulation therapy in chronic heart failure with preserved/mildly reduced ejection fraction: ANTHEM-HFpEF study results
Kumar et al. · International Journal of Cardiology · 2023 · n = 52
controlled trialsiVNSVagal stimulation in heart failure
Dusi et al. · Herz · 2021
controlled trialsiVNSAutonomic regulation therapy via left or right cervical vagus nerve stimulation in patients with chronic heart failure: results of the ANTHEM-HF trial
Premchand et al. · Journal of Cardiac Failure · 2014 · n = 60
controlled trialsiVNSLong-term Follow-Up of Patients with Heart Failure and Reduced Ejection Fraction Receiving Autonomic Regulation Therapy in the ANTHEM-HF Pilot Study
Sharma et al. · International Journal of Cardiology · 2021 · n = 60
observational studiesiVNSVagus Nerve Stimulation Provides Multiyear Improvements in Autonomic Function and Cardiac Electrical Stability in the ANTHEM-HF Study
Nearing et al. · Journal of Cardiac Failure · 2021 · n = 25
observational studiesiVNSLong-term vagal stimulation for heart failure: Eighteen month results from the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) trial
De Ferrari et al. · International Journal of Cardiology · 2017 · n = 96
observational studiesiVNSExtended Follow-Up of Patients With Heart Failure Receiving Autonomic Regulation Therapy in the ANTHEM-HF Study
Premchand et al. · Journal of Cardiac Failure · 2016 · n = 49
observational studiesiVNS