--- title: BackBeat CNT™ Treatment for Hypertension | Orchestra BioMed description: A patented, intelligent bioelectronic treatment for hypertension. Designed to immediately, substantially and persistently lower blood pressure. --- [![OBM_Logo_Orange_White_RGB-4](https://7401945.hs-sites.com/hubfs/OBM_Logo_Orange_White_RGB-4.png) ](https://7401945.hs-sites.com/) ** ** Close Our Innovations ## BackBeat CNT ™ (AVIM Therapy) # A patented, investigational bioelectronic treatment for hypertension BackBeat Cardiac Neuromodulation Therapy™, also known as atrioventricular interval modulation (AVIM) therapy, is designed to substantially, immediately and persistently lower blood pressure. - [Technology](https://7401945.hs-sites.com/backbeat-cnt#tab-1) - [Data](https://7401945.hs-sites.com/backbeat-cnt#tab-2) - [Partner](https://7401945.hs-sites.com/backbeat-cnt#tab-3) ![bioelectronic therapy](https://7401945.hs-sites.com/hubfs/adjustable-biolectronic.png) Programmable and adjustable bioelectronic therapy designed to lower blood pressure while simultaneously modulating the autonomic nervous system (ANS). ![moderato](https://7401945.hs-sites.com/hubfs/pacemaker-dc.png) Designed to leverage standard rhythm management device hardware, such as dual-chamber pacemaker, utilizing the same implant procedure and lead positions. Close ## Patented Bioelectronic Therapy Designed to immediately, substantially and persistently lower blood pressure. ![lowers blood pressure](https://7401945.hs-sites.com/hubfs/lower-blood-pressure.svg) Designed to substantially lower blood pressure through programmed pacing. ![maintains lowered blood pressure](https://7401945.hs-sites.com/hubfs/bloodpressure.svg) Designed to maintain reduction by modulating autonomic nervous system (ANS) response through programmed variable pressure patterns. ![multiple medications](https://7401945.hs-sites.com/hubfs/multiplemedications.svg) Designed to work automatically without relying on patient compliance with background antihypertension medications. ## Leverages Standard Rhythm Management Devices Designed to readily incorporate into existing devices and treatment pathways. ![readily incorporated](https://7401945.hs-sites.com/hubfs/existing-device.svg) Can be readily incorporated into existing cardiac rhythm management devices such as pacemakers using standard implant and lead placement techniques. ![adaptable](https://7401945.hs-sites.com/hubfs/paradigm-care.svg) Designed to be rapidly adaptable for hypertensive patients already indicated for a pacemaker. ![data-icon](https://7401945.hs-sites.com/hubfs/data-icon-1.svg) Atrioventricular interval modulation (AVIM) therapy is supported by encouraging preclinical and clinical data. In MODERATO I and II pilot studies, the therapy demonstrated statistically significant reductions in blood pressure in patients with hypertension and an indication for a pacemaker. ## Clinical AVIM therapy showed promising results in MODERATO II, a prospective, multi-center, randomized, double-blind study of pacemaker patients with persistent hypertension including 88.5% with isolated systolic hypertension (ISH)1,2 --- ## 11.1↓ mmHg 24-Hour aSBP3 at 6 months --- ## 17.5↓ mmHg in oSBP3 at 2 years --- ## 0% MACE3 at 6 months --- ## 85% of patients with reduction in aSBP --- Significant Reduction in 24-Hr aSBP and oSBP ![Significant Reduction in 24-Hr aSBP and oSBP](https://7401945.hs-sites.com/hubfs/avim-graph.jpg) [Results were presented during the Breakthrough Science Session at TCT 2019](https://7401945.hs-sites.com/hubfs/backbeat-cnt-moderato-ii-data-results.pdf) [Data published in the American Heart Association journal](https://www.ahajournals.org/doi/10.1161/JAHA.120.020492) Significant Reduction in aSBP 24 Hours a Day ![Significant Reduction in aSBP 24 Hours a Day](https://7401945.hs-sites.com/hubfs/avim-graph-right.jpg)   MODERATO I, an open-label, single-arm, multi-center, prospective study of 27 patients with persistent hypertension and an indication for a pacemaker demonstrated a substantial reduction in blood pressure sustained out to 2 years.6,7 --- ## 10.1↓ mmHg 24-Hour aSBP at 3 months --- ## 13.1↓ mmHg in oSBP at 2 years --- ## 87.5% of patients with reduction in aSBP --- Significant Reduction in 24-Hr aSBP ![1 Day 1 Month and 3 Months aSBP](https://7401945.hs-sites.com/hubfs/osbp-left-1.jpg) Significant Reduction in oSBP Maintained Through 24 Months ![oSBP from 1-24 months](https://7401945.hs-sites.com/hubfs/oSBP-24-months.jpg) ## Preclinical Preclinical Delivery of AVIM therapy significantly reduced 24-hour systolic and diastolic blood pressures in a canine model. The reduction occurred immediately upon activation of therapy and was maintained for its full duration. Significantly Reduced Blood Pressure ![backbeat cnt preclinical chart](https://7401945.hs-sites.com/hubfs/backbeat-cnt-preclinical-chart.png) *Data on file 1Kalaras et al. Journal of the American Heart Association. 2021;10:e020492. [https://doi.org/10.1161/JAHA.120.020492](https://doi.org/10.1161/JAHA.120.020492). 2Burkhoff MODERATO II Study 2-Year Results TCT 2021. 3Ambulatory systolic blood pressure (aSBP), office systolic blood pressure (oSBP) and Major Cardiac Advance Events (MACE), including death, heart failure, clinically significant arrhythmias (i.e., persistent or increased atrial fibrillation, serious ventricular arrhythmias), myocardial infarction, stroke and renal failure in treatment group calculated per patient. 4Compared to pre-activation. 524-Hr aSBP Control (n=19). 1 control patient could not be measured despite repeat measurement (patient had extremely high blood pressure) 6Neuzil et al. Journal of the American Heart Association. 2017;6:e006974. [https://doi.org/10.1161/JAHA.117.006974](https://doi.org/10.1161/JAHA.117.006974). 7Burkhoff MODERATO I Study 2-Year Results TCT 2018. 8Compared to pre-activation. 916 patients had aSBP at pre-activation. 1021 of 27 patients continued after completion of study at 3 months to be followed for 2 years ![data-icon](https://7401945.hs-sites.com/hubfs/partner-icon.svg) Orchestra BioMed entered into a global strategic collaboration with Medtronic to develop AVIM therapy as a bioelectronic treatment for hypertension in patients indicated for a cardiac pacemaker. ![Orchestra BioMed logo](https://7401945.hs-sites.com/hubfs/orchestra-logo.png)![Medtronic logo](https://7401945.hs-sites.com/hubfs/medtronic.png) ![quote icon](https://7401945.hs-sites.com/hubfs/obm-quote.svg) "As the global leader in advanced cardiac pacing therapies, Medtronic is the ideal partner to help us develop AVIM therapy for the treatment of hypertension, which is remarkably common and drives significant health risk in the pacemaker population. This exemplifies our commitment to accelerating high-impact medical innovations with global medical technology leaders." David Hochman, Chairman, CEO and Founder, Orchestra BioMed About the Agreement - Orchestra BioMed will conduct a global pivotal trial to further evaluate the safety and efficacy of AVIM therapy in lowering blood pressure in patients who have been indicated for and recently received a cardiac pacemaker implant - Medtronic will provide Orchestra BioMed with development, clinical and regulatory support for the multi-national pivotal study - Medtronic will have the global rights to commercialize AVIM therapy for this target population following regulatory approval - Orchestra BioMed will share in the revenues generated from Medtronic’s sale of AVIM therapy-enabled pacing systems BackBeat CNT™ (also known as AVIM therapy) is investigational and not commercially approved. [![Orchestra BioMed logo](https://7401945.hs-sites.com/hs-fs/hubfs/OBM_Logo_Orange_White_RGB.png?width=260&name=OBM_Logo_Orange_White_RGB.png) ](https://7401945.hs-sites.com/) [**](https://twitter.com/orchestrabiomed) [**](https://www.linkedin.com/company/orchestra-biomed/) --- © 2026 Orchestra BioMed Inc. Virtue®, BackBeat CNT™ FreeHold Duo®, FreeHold Trio® and Orchestra BioMed™ are trademarks of Orchestra BioMed. All other trademarks are trademarks of their respective owners. SM-0020 Rev 01 [Disclaimer](https://7401945.hs-sites.com/disclaimer)