Sohrabi_et_al_2021.pdf (1.12 MB)
Download fileContemporary management of heart failure patients with reduced ejection fraction: the role of implantable devices and catheter ablation
journal contribution
posted on 2023-07-26, 15:29 authored by Catrin Sohrabi, Syed Ahsan, Alexandros Briasoulis, Emmanuel Androulakis, Gerasimos Siasos, Neil T. Srinivasan, Nikolaos PapageorgiouHeart failure (HF) is a complex clinical syndrome characterised by significant morbidity and mortality worldwide. Evidence-based therapies for the management of HF include several well-established neurohormonal antagonists and antiarrhythmic drug therapy to mitigate the onset of cardiac arrhythmia. However, the degree of rate and rhythm control achieved is often suboptimal and mortality rates continue to remain high. Implantable cardioverter-defibrillators (ICDs), cardiac resynchronization (CRT), and combined (CRT-D) therapies have emerged as integral and rapidly expanding technologies in the management of select patients with heart failure with reduced ejection fraction (HFrEF). ICDs treat ventricular arrhythmia and are used as primary prophylaxis for sudden cardiac death, while CRT resynchronizes ventricular contraction to improve left ventricular systolic function. Left ventricular assist device therapy has also been shown to provide clinically meaningful survival benefits in patients with advanced HF, and His-bundle pacing has more recently emerged as a safe, viable, and promising pacing modality for patients with CRT indication. Catheter ablation is another important and well-established strategy for managing cardiac arrhythmia in HF, demonstrating superior efficacy when compared with antiarrhythmic drug therapy alone. In this article, we provide a comprehensive and in-depth evaluation of the role of implantable devices and catheter ablation in patients with HFrEF, outlining current applications, recent advances, and future directions in practice.
History
Refereed
- Yes
Volume
22Issue number
2Page range
415Publication title
Reviews in Cardiovascular MedicineISSN
2153-8174External DOI
Publisher
IMR PressFile version
- Published version
Language
- eng