[Heart failure unit: 1 year experience]

Many factors such as aging and pharmacologic and surgical progress contribute to the growing of organizational problems of health care for patients with severe chronic heart failure. Since March 16, 1992, in the Medical Center of Montescano, an experimental model (Heart Failure Unit) of health assistance has been in development, taking into account the assistance and observational needs of such patients. During the first year of activity, 173 patients were treated in the Unit, for a total of 307 admissions. In-hospital complications were 5 deaths, 91 severe heart decompensations, 25 severe ventricular tachyarrhythmias, 17 infections, 11 severe bradyarrhythmias, 6 instances of acute heart failure due to atrial arrhythmias, 5 unstable angina episodes, 3 thromboembolisms, and 3 neuropsychiatric disorders. During the follow-up until August 15, 1993, 27 patients died and 19 underwent heart transplantation. Our experience focused on realizing the following goals: 1) to organize a fit hospital environment and adequate nursing; 2) to pursue the autonomy and independence of the patients; 3) to routinely cooperate in a multidisciplinary team; 4) to offer continuity of care to patients.