NECTAR-HR Trial gives patients a new lease of life

Around a million Britons have heart failure, causing fatigue and breathlessness. John Joyner, 76, a former teacher and now a businessman from Weston-Super-Mare, was the first to undergo a pioneering new treatment.

John had always thought of himself as being relatively fit, having been a marathon runner for many years. However, one evening whilst on holiday with friends he started to feel unwell, woozy and nauseous. His wife, a trained nurse, insisted on taking him to hospital. Shortly after arriving there he suffered a heart attack.

After staying in hospital for two weeks John flew home and was prescribed aspirin by his GP to prevent another clot forming and giving him another heart attack. John could no longer run marathons but keen not to lose all his fitness he embarked on walking holidays instead.

But a few years ago he started to feel more tired, and  get out of breath more quickly whilst on walks. His GP referred him to the Bristol Heart Institute where he was diagnosed with heart failure - the attack had weakened his heart and it was no longer able to pump blood properly.

John explains, "I was prescribed medication, including beta blockers, and I also had a tiny defibrillator implanted in my chest. The doctors said that the body tries to compensate for heart failure by making the organ beat faster to get more blood around the body. But this puts strain on your heart, which can fall into an abornal rhythm. The implant would stop that by delivering a small electric shock."

Shortly after having the implant fitted John was told that the hospital was running a new trial using an implanted simulator in the chest to make the heart work more efficiently. John met with Dr Angus Nightingale, the clinician leading the project, who explained that the idea was to stimulate the vagus nerve, which runs up the neck and is part of the system that calms the heart. This would hopefully slow down the heart and ease the strain. John was the first patient to undergo this treatment in the UK and the device was implanted under general anaesthetic in an operation that took less than an hour.

John stayed in hospital overnight for observation and within a couple of days was back to normal. As the trial was randomised John did not know for six months if his implant had been turned on - but he suspected it was as his breathlessness started to ease. He will still have to take medication for life - but he feels that he now has so much more energy.

The study is sponsored by the Boston Scientific Corporation and is being carried out at 24 sites across Europe. For more information on the trial please visit http://clinicaltrials.gov/ct2/show/NCT01385176