Minimally invasive treatment for heart failure patients, Barostim, comes to MUSC Health Midlands

February 15, 2024
Man in a suit standing at a podium. There is a sign saying MUSC Health behind him.
“I want to make sure that everything that they offer at Charleston, except for transplant, will be offered here at MUSC Columbia” for heart failure patients, says cardiologist Dr. Joshua Coney. Photo by Kati Van Aernum

Joshua “Bear” Coney, M.D., is offering a treatment to patients in Columbia that sounds a little like his nickname but takes things in a totally different direction. Barostim, a minimally invasive heart failure treatment, is anything but dangerous, Coney said. It can be life-changing.

“In the last year, I've noticed that patients with Barostim have had a significant improvement in their quality of life. My patients seem to be happier. They have less shortness of breath; they're able to walk longer, and they are thankful for care,” the MUSC Health Columbia cardiologist said.

Heart failure affects more than 6 million American adults, according to the Centers for Disease Control and Prevention. They get short of breath when doing routine activities or even lying down. They can also gain weight and see swelling in parts of the body, including feet, ankles and stomach and feel fatigued.

That’s a lot of discomfort that can have serious consequences if left untreated. Heart failure can ultimately lead to the need for a heart transplant.

So what is Barostim? A much less invasive way to help, Coney said.

Doctors at MUSC Health became the first at an academic medical center and only the second in the world to implant Barostim systems in 2022. Coney was working in Charleston at the time. When he moved to Columbia, he knew he wanted to offer that treatment to heart failure patients there.

“Barostim is a pressure monitor stimulator. It monitors pressures inside of the neck, and it stimulates a nerve that is attached to the heart,” Coney explained. 

Drawing of a person's torso and head. At the top it says Barostim outsmart the heart. In the body,  you see drawing of the brain and two pieces of the Barostim device. 
This image from Barostim shows the piece on the left that monitors pressures in the neck and stimulates a nerve attached to the heart.

It’s usually used in patients who already have a defibrillator, a device that sends an electric current to the heart to stop an arrhythmia. Barostim can offer further improvement, Coney said, making a patient’s circulation run more smoothly. That allows them to move about normally and become more active.

“Barostim is implanted in two places. There's a wire that's connected to a battery that sends the electrical pulses into the neck. And so the device and battery are implanted in the right side of your chest. And then a tunnel is made under your skin with the wire, and it is sewn in on top of the nerve in your neck that stimulates the heart,” Coney said.

It’s less invasive than some other heart failure treatments. “It's just under the skin. It doesn't go into the heart. It doesn't go into the body.”

Coney described the criteria for good candidates. “So you have to have heart failure, for one. And heart failure is when your heart muscle is squeezing less than 40%. So if you have heart failure, and you're already on medicine, and you can't tolerate any increases, or if you are at the maximum dose and you're still having symptoms, the Barostim will help alleviate the symptoms. Additionally, it will also help decrease the doses of the additional directs or water pills that patient needs.”

It can also reduce the odds that a patient will eventually need an advanced treatment such as a heart transplant or a left ventricular assist device. Coney said it’s important to make the Barostim treatment available to as many people who qualify as possible. 

His region of MUSC Health, the Midlands, includes four health care sites: two hospitals in Columbia plus MUSC Health Fairfield Emergency Care and Imaging and MUSC Health Kershaw Medical Center. They all work together to ensure patients get the care they need, including Barostim for people who qualify. They also work closely with the Heart and Vascular Center at MUSC Health in Charleston.

“I want to make sure that everything that they offer at Charleston, except for transplant, will be offered here at MUSC Columbia,” Coney said.

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