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Implantable devices for heart failure monitoring and therapy
Maxwell Eyram Afari1, Wajih Syed2, Lana Tsao2
1Division of Cardiovascular Medicine, Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Brighton, MA, 02135, USA. maxieafari@yahoo.co.uk.
Insights
Heart failure (HF) remains a major health challenge with high mortality. Innovative implantable devices offer new monitoring and treatment options for patients with advanced heart failure.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Heart failure (HF) is a growing cardiovascular epidemic with significant morbidity, mortality, and increasing healthcare costs.
- Despite advances in pharmacologic therapy, 5-year survival for HF remains suboptimal at 61%, highlighting unmet clinical needs.
- Patients face challenges including lifestyle modifications, treatment adherence, financial constraints, and side effects, particularly those with advanced (ACC/AHA stage D) or non-transplant-candidate (ACC/AHA stage C) heart failure.
Purpose of the Study:
- To review innovative implantable devices for monitoring and treating heart failure.
- To explore emerging technologies addressing the limitations of current heart failure management.
- To discuss devices under investigation or approved for add-on therapy in heart failure patients.
Main Methods:
- This is a review article, synthesizing information from existing literature and clinical data.
- The review focuses on implantable devices as add-on therapy for heart failure.
- It covers devices in various stages of development and approval.
Main Results:
- The review discusses various innovative implantable devices for heart failure management.
- These devices aim to improve monitoring and treatment efficacy.
- The focus is on add-on therapies for patients not candidates for advanced treatments like heart transplant or LVADs.
Conclusions:
- Implantable devices represent a promising area for improving heart failure care.
- These technologies address challenges in monitoring and treatment adherence.
- Further development and integration of devices are crucial for managing the increasing burden of heart failure.
Abstract:
Heart failure (HF), the cardiovascular epidemic of the twenty-first century, is associated with significant comorbidities and high mortality. The prevalence of HF is estimated around 6.5 million people and is expected to increase to 8 million by the year 2030. The associated costs to care for these patients continue to increase. Despite the advancement of pharmacologic therapy with significant improvement in morbidity and mortality, the 5-year survival for heart failure still stands at 61%. The challenges faced by HF patients include difficulty with lifestyle modifications, nonadherence to complex medical regimens, financial limitations, lack of access to medical care, and unfavorable side effects. The sickest HF patients, who are ACC/AHA stage D, have advanced therapeutic options such as left ventricular assist devices and orthotopic heart transplant; however, the majority of patients are ACC/AHA stage C and/or not candidates for such advanced care. With constraints placed on hospitals by Medicare on HF readmissions as well as the multiple comorbidities imposed by this disease, intense interest is focused on the development of implantable devices as add-on therapy. This review discusses the innovative devices under varying stages of investigation or approved for monitoring and treatment of HF.
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