Device therapy for heart failure management

Given the prevalence of heart failure (HF) and the interdisciplinary nature of device therapy, it is paramount that cardiologists not only understand the current landscape of goal-directed medical therapy, but also the ongoing efforts in device development. Thus, we aim to provide a practical overview of the broad approaches being utilized in the burgeoning field of device-based therapies for heart failure.

Currently, a diverse array of devices for HF treatment is being developed and tested, each targeting distinct aspects of HF pathophysiology. These innovative solutions encompass a wide spectrum, ranging from devices enabling remote monitoring of HF associated physiological parameters, to those focused on creating interatrial shunts and effecting structural modifications of the left ventricle, as well as to those designed to modulate the autonomic nervous system and diaphragm. Notably, a subset of these emerging devices is directed towards treating patients with heart failure with preserved ejection fraction, a population that has traditionally not been served by device-based therapies.

In recent decades, there has been a remarkable surge in the development and utilization of device-based treatments for managing HF. It is important for physicians to be familiar with these devices, their mechanisms of action, and their applications.