Bionic cardiology is the medical science of exploring electronic control of the body, usually via the neural system. Mimicking or modifying
biological regulation is a strategy used to combat diseases. Control of ventricular rate during
atrial fibrillation by selective vagal stimulation, suppression of
ischemia-related
ventricular fibrillation by vagal stimulation, and reproduction of neurally commanded heart rate are some examples of bionic treatment for
arrhythmia. Implantable radio-frequency-coupled on-demand carotid sinus stimulators succeeded in interrupting or preventing anginal attacks but were replaced later by coronary revascularization. Similar but fixed-intensity carotid sinus stimulators were used for
hypertension but were also replaced by drugs. Recently, however, a self-powered implantable device has been reappraised for the treatment of
drug-resistant
hypertension. Closed-loop
spinal cord stimulation has successfully treated severe
orthostatic hypotension in a limited number of patients.
Vagal nerve stimulation is effective in treating
heart failure in animals, and a small-size clinical trial has just started. Simultaneous corrections of multiple hemodynamic abnormalities in an acute decompensated state are accomplished simply by quantifying fundamental cardiovascular parameters and controlling these parameters. Bionic cardiology will continue to promote the development of more sophisticated device-based
therapies for otherwise untreatable diseases and will inspire more intricate applications in the twenty-first century.