Personalised treatment strategies in heart failure: A literature review and new proposed algorithm for device therapy...

Area of Science:

• Cardiology
• Medical Devices
• Clinical Trials

Background:

• Heart failure (HF) presents a significant global health burden with high morbidity and mortality.
• Despite therapeutic advancements, HF management remains challenging.
• Device therapy plays a crucial role in improving outcomes for HF patients.

Purpose of the Study:

• To review landmark clinical trials in heart failure device therapy.
• To discuss novel prognostic and monitoring methods for precise patient assessment.
• To propose a new algorithm for personalized device therapy selection in heart failure.

Main Methods:

• Review of key clinical trials on implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT).
• Discussion of emerging technologies like conduction system pacing.
• Exploration of prognostic tools including impedance cardiography and dobutamine stress echocardiography.

Main Results:

• Landmark trials have established the efficacy of ICDs and CRT in specific HF populations.
• Novel monitoring techniques offer enhanced precision in patient evaluation.
• A proposed four-step algorithm integrates risk stratification, electrical/functional assessment, and prognostic factors for tailored therapy.

Conclusions:

• Personalized device therapy selection is crucial for optimizing heart failure management.
• Integrating evidence-based interventions with phenotype-driven decisions improves patient quality of life.
• The proposed algorithm facilitates a proactive, individualized approach to heart failure care.