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Devices in heart failure; diagnosis, detection and disease modification
John Gierula1, Mark T Kearney1, Klaus K Witte1
1Division of Cardiovascular and Diabetes Research, Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS29JT, UK.
British Medical Bulletin
|January 18, 2018
Summary
Electronic cardiac devices are crucial for chronic heart failure (CHF) management. While cardiac resynchronization therapy (CRT) shows benefits, implantable cardioverter defibrillators (ICDs) and remote monitoring require further research for optimal CHF treatment.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Implantable cardiac devices are integral to managing chronic heart failure (CHF).
- Current therapeutic strategies involve various electronic devices tailored to patient needs.
Purpose of the Study:
- To review current CHF treatments utilizing electronic cardiac devices.
- To discuss areas of ongoing debate and emerging technologies in device therapy for CHF.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, MEDLINE, EMBASE).
- Relevant national and international clinical guidelines were reviewed.
Main Results:
- Cardiac resynchronization therapy (CRT) is beneficial for select CHF patients, whereas excessive right ventricular pacing is detrimental.
- The benefit of implantable cardioverter defibrillators (ICDs) for all patients is debated, and remote monitoring has not shown clear benefits in CHF.
- Device-based optimization strategies are an area of active development.
Conclusions:
- Personalized device therapy, optimizing CRT delivery, and refining ICD use are key areas for future research.
- Further investigation is needed regarding device management at the time of ICD replacement.
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