Next Article in Journal
Revisiting Abdominal Pain in IBS: From Pathophysiology to Targeted Management with Algerine Citrate/Simeticone
Previous Article in Journal
Clinical Soft Tissue Adaptation to Biomechanical Modulation with the Bone Protection System (BPS): A Two-Case Report in Thin-Biotype Patients
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JCM
Volume 15
Issue 2
10.3390/jcm15020719
jcm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Impact of Sacubitril/Valsartan on Cardiac Autonomic Function Assessed Using Physiological Data from Implantable Cardioverter-Defibrillators

by
Lucy Barone
1,*,
Domenico Sergi
1,
Giampiero Maglia
2,
Luca Bontempi
3,
Marzia Giaccardi
4,5,
Matteo Baroni
6,
Claudia Amellone
7,
Antonio Curnis
8,9,
Giuliano D’Alterio
10,
Davide Saporito
11,
Paolo Vinciguerra
3,
Simone Cipani
4,
Patrizio Mazzone
6,
Massimo Giammaria
7,
Gianfranco Mitacchione
8,9,
Daniele Masarone
10,
Francesca Fabbri
11,
Andrea Vannelli
1,
Irene Baldassarre
12,
Martina Del Maestro
12,
Daniele Giacopelli
12,
Eduardo Celentano
13,
Gabriele Zanotto
14 and
Francesco Barillà
15add Show full author list remove Hide full author list
1
Department of Systems Medicine, Policlinico Tor Vergata: Fondazione PTV, 00133 Rome, Italy
2
Tirrenia Hospital, 87021 Belvedere Marittimo, Italy
3
Department of Cardiology, Bolognini Hospital, 24068 Seriate, Italy
4
Department of Cardiology, Santa Maria Annunziata Hospital, 50012 Florence, Italy
5
Pediatric Cardiology Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, Italy
6
De Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, 20162 Milan, Italy
7
Cardiology Department, Maria Vittoria Hospital, 10144 Turin, Italy
8
Department of Electrophysiology and Cardiac Pacing, ASST Spedali Civili, 25121 Brescia, Italy
9
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
10
Cardiology Department, Monaldi Hospital, 80131 Naples, Italy
11
Cardiology, Infermi Hospital, 47923 Rimini, Italy
12
Clinical Research Unit, BIOTRONIK Italia, 20093 Cologno Monzese, Italy
13
Department of Electrophysiology, Humanitas Gavazzeni, 24125 Bergamo, Italy
14
Azienda Ulss 9 Scaligera, 37069 Villafranca, Italy
15
Health Sciences, UniCamillus—Saint Camillus International University, 00131 Rome, Italy
 
add Show full affiliation list
 
remove Hide full affiliation list
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(2), 719; https://doi.org/10.3390/jcm15020719
Submission received: 2 December 2025 / Revised: 5 January 2026 / Accepted: 14 January 2026 / Published: 15 January 2026
(This article belongs to the Section Cardiovascular Medicine)
Versions Notes

Abstract

Background/Objectives: Sacubitril/Valsartan is a cornerstone therapy to improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to investigate the effect of Sacubitril/Valsartan on cardiac autonomic balance using physiological sensor data obtained from implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy defibrillators (CRT-Ds). Methods: This observational study involved 54 ICD and CRT-D patients who initiated Sacubitril/Valsartan therapy to treat HFrEF. The evaluated key parameters included heart rate variability (HRV), 24 h mean heart rate (24 h-HR), and nocturnal heart rate (nHR). Device electrical parameters and ventricular arrhythmias were also assessed. The data were collected by remote monitoring and averaged over a 7-day window at baseline (before treatment) and at 3 and 12 months after treatment initiation. Results: Sacubitril/Valsartan significantly improved HRV at 3 months (from 78.6 ms [interquartile range: 54.2–104.6] to 80.8 ms [60.8–108.0]; p = 0.041), reduced 24 h-HR (from 73.2 bpm [67.3–77.7] to 69.9 bpm [64.2–75.7]; p = 0.016), and reduced nHR (from 63.0 bpm [58.1–70.0] to 60.4 bpm [56.0–68.6]; p = 0.028). No significant changes in HRV, 24 h-HR, and nHR were observed between 3- and 12-month follow-up. The device electrical parameters were not influenced by the treatment. While the overall ventricular arrhythmia burden did not change post-treatment, patients with pre-treatment arrhythmias experienced a significant reduction in episodes from 2.97 (pre-treatment) to 0.82 (post-treatment) events per 100 patient years (p = 0.008). Conclusions: Sacubitril/Valsartan therapy in HFrEF patients was associated with statistically significant changes in cardiac autonomic indices, including a small increase in HRV and a slight reduction in heart rate, mainly during the first three months of treatment.
Keywords: sacubitril/valsartan; heart failure; implantable cardioverter-defibrillator; remote monitoring; electrical parameters sacubitril/valsartan; heart failure; implantable cardioverter-defibrillator; remote monitoring; electrical parameters

Share and Cite

MDPI and ACS Style

Barone, L.; Sergi, D.; Maglia, G.; Bontempi, L.; Giaccardi, M.; Baroni, M.; Amellone, C.; Curnis, A.; D’Alterio, G.; Saporito, D.; et al. Impact of Sacubitril/Valsartan on Cardiac Autonomic Function Assessed Using Physiological Data from Implantable Cardioverter-Defibrillators. J. Clin. Med. 2026, 15, 719. https://doi.org/10.3390/jcm15020719

AMA Style

Barone L, Sergi D, Maglia G, Bontempi L, Giaccardi M, Baroni M, Amellone C, Curnis A, D’Alterio G, Saporito D, et al. Impact of Sacubitril/Valsartan on Cardiac Autonomic Function Assessed Using Physiological Data from Implantable Cardioverter-Defibrillators. Journal of Clinical Medicine. 2026; 15(2):719. https://doi.org/10.3390/jcm15020719

Chicago/Turabian Style

Barone, Lucy, Domenico Sergi, Giampiero Maglia, Luca Bontempi, Marzia Giaccardi, Matteo Baroni, Claudia Amellone, Antonio Curnis, Giuliano D’Alterio, Davide Saporito, and et al. 2026. "Impact of Sacubitril/Valsartan on Cardiac Autonomic Function Assessed Using Physiological Data from Implantable Cardioverter-Defibrillators" Journal of Clinical Medicine 15, no. 2: 719. https://doi.org/10.3390/jcm15020719

APA Style

Barone, L., Sergi, D., Maglia, G., Bontempi, L., Giaccardi, M., Baroni, M., Amellone, C., Curnis, A., D’Alterio, G., Saporito, D., Vinciguerra, P., Cipani, S., Mazzone, P., Giammaria, M., Mitacchione, G., Masarone, D., Fabbri, F., Vannelli, A., Baldassarre, I., ... Barillà, F. (2026). Impact of Sacubitril/Valsartan on Cardiac Autonomic Function Assessed Using Physiological Data from Implantable Cardioverter-Defibrillators. Journal of Clinical Medicine, 15(2), 719. https://doi.org/10.3390/jcm15020719

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Article metric data becomes available approximately 24 hours after publication online.
Back to TopTop