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09.05.2018 | Main topic

Device therapy in heart failure with reduced ejection fraction—cardiac resynchronization therapy and more

verfasst von: Priv.-Doz. Dr. D. Duncker, Prof. Dr. C. Veltmann

Erschienen in: Herz | Ausgabe 5/2018

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Abstract

In patients with heart failure with reduced ejection fraction (HFrEF), optimal medical treatment includes beta-blockers, ACE inhibitors/angiotensinreceptor-neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists, and ivabradine when indicated. In device therapy of HFrEF, implantable cardioverter-defibrillators and cardiac resynchronization therapy (CRT) have been established for many years. CRT is the therapy of choice (class I indication) in symptomatic patients with HFrEF and a broad QRS complex with a left bundle branch block (LBBB) morphology. However, the vast majority of heart failure patients show a narrow QRS complex or a non-LBBB morphology. These patients are not candidates for CRT and alternative electrical therapies such as baroreflex activation therapy (BAT) and cardiac contractility modulation (CCM) may be considered. BAT modulates vegetative dysregulation in heart failure. CCM improves contractility, functional capacity, and symptoms. Although a broad data set is available for BAT and CCM, mortality data are still lacking for both methods. This article provides an overview of the device-based therapeutic options for patients with HFrEF.

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Titel: Device therapy in heart failure with reduced ejection fraction—cardiac resynchronization therapy and more
verfasst von: Priv.-Doz. Dr. D. Duncker
Prof. Dr. C. Veltmann
Publikationsdatum: 09.05.2018
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 5/2018
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-018-4710-6

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