Contemporary management of heart failure patients with reduced ejection fraction: the role of implantable devices and catheter ablation

Sohrabi, Catrin and Ahsan, Syed and Briasoulis, Alexandros and Androulakis, Emmanuel and Siasos, Gerasimos and Srinivasan, Neil T. and Papageorgiou, Nikolaos (2021) Contemporary management of heart failure patients with reduced ejection fraction: the role of implantable devices and catheter ablation. Reviews in Cardiovascular Medicine, 22 (2). p. 415. ISSN 2153-8174

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Official URL: https://doi.org/10.31083/j.rcm2202047

Abstract

Heart 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.

Item Type: Journal Article
Keywords: Heart failure, HFrEF, Catheter ablation, Implantable device, Atrial fibrillation, Ventricular tachycardia, Prevention
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 19 Aug 2021 11:33
Last Modified: 09 Sep 2021 18:50
URI: https://arro.anglia.ac.uk/id/eprint/706843

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