Cardiac Output Autonomic Stimulation Therapy for Acute Heart Failure (COAST-AHF)

Exclusion Criteria

• •1. Systolic Blood Pressure \< 90 mmHg or \> 160 mmHg
• •2. Catecholamine or inotropic therapy within the previous 48 hours
• •3. Levosimendan within the previous 72 hours
• •4. Chronic outpatient catecholamine or inotropic therapy
• •5. Presence of implanted pacemaker, implantable cardioverter defibrillator or cardiac resynchronization therapy device
• •6. Presence of or prior vagal nerve stimulator
• •7. Coronary artery bypass graft surgery, percutaneous coronary intervention, acute myocardial infarction, or valve replacement within prior 1 month
• •8. Second or third degree heart block
• •9. History of atrial or ventricular arrhythmias
• •10. History of mitral or aortic valve stenosis or regurgitation
• •11. Hypertrophic obstructive or infiltrative cardiomyopathy
• •12. Prior vagotomy
• •13. Prior heart transplant
• •14. Narrow angle glaucoma
• •15. Renal failure - either on dialysis or serum creatinine \> 2.0 mg/dl
• •16. Hepatic failure - bilirubin, serum glutamic oxaloacetic transaminase, or serum glutamic pyruvic transaminase \> four times upper limit of normal
• •17. Life expectancy \< 12 months per physician judgment
• •18. Women who are pregnant
• •19. Allergy to fentanyl, midazolam, propofol, eggs, egg products, soybeans, or soy products
• •20. Subjects unwilling or unable to provide consent