Cardiac Implantable Electronic Device Therapy in Heart Failure
Ayman A Hussein1, Bruce L Wilkoff1
1From the Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH.
Circulation Research
|May 24, 2019
Summary
The growing number of heart failure patients necessitates advanced device therapies for managing arrhythmias and preventing sudden cardiac death. This review covers cardiac implantable electronic devices for heart failure, focusing on resynchronization and risk reduction.
Area of Science:
- Cardiology
- Biomedical Engineering
- Clinical Medicine
Background:
- Heart failure patient populations are expanding, presenting complex clinical management challenges.
- Cardiac arrhythmia and advanced heart failure syndromes require innovative treatment strategies.
- Device therapy is crucial for managing life-threatening arrhythmias in heart failure patients.
Purpose of the Study:
- To review the application of cardiac implantable electronic devices in heart failure management.
- To focus on the roles of these devices in sudden cardiac death prevention.
- To examine the use of devices for cardiac resynchronization therapy.
Main Methods:
- Literature review of published evidence on device therapy in heart failure.
- Analysis of current technologies and their clinical impact.
- Discussion of evolving technologies in cardiac device management.
Main Results:
- Device therapy is essential for managing arrhythmias and heart failure.
- Cardiac implantable electronic devices play a key role in sudden cardiac death prevention.
- Cardiac resynchronization therapy improves outcomes in select heart failure patients.
Conclusions:
- Cardiac implantable electronic devices are indispensable in modern heart failure care.
- Ongoing technological advancements promise further improvements in patient outcomes.
- Device therapy addresses critical needs in arrhythmia management and heart failure progression.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
289
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
289
01:29Heart Failure II: Pathophysiology
812
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
812
01:17Pathophysiology of Heart Failure
3.1K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
3.1K
01:27Heart Failure I: Introduction
751
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
751
01:22Heart Failure Drugs: Diuretics
846
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
846
01:30Heart Failure V: Medical Management
239
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
239