HEART FAILURE DEVICE THERAPY
Devices are used to support medications
Medications are the number one tool for treatment of heart failure. The purpose of each medication is different. Some target the cause of heart failure. Some are used to relieve heart failure symptoms while some others are used to slow the progression of heart failure and protect from complications. Sometimes however medications alone are not enough to slow heart failure and additional treatments are needed. A number of heart devices have been shown to be very beneficial when added to medications.
Heart failure devices fall into two broad categories: diagnostic and therapeutic.
Diagnostic Devices-Loop Recorders
Diagnostic devices are used to monitor heart failure and can track signs of worsening and can often detect problems before symptoms are noticed.
A loop recorder is a diagnostic device which is implanted under the skin. Loop recorders monitor and record the heart’s rhythm continuously for up to three years. By reviewing the findings along with the timing of new or worsening symptoms, we are able to discern whether the two are related. Abnormal rhythms such as atrial fibrillation are dangerous in their own right as well as being able to cause worsening heart failure.
Diagnostic Device: CARDIOMEMS Device
Another implanted diagnostic device we use to monitor heart failure is called CardioMEMS. This is a tiny pressure-sensing device that is inserted into one of the pulmonary arteries where it quietly monitors changes in pressure. The tiny device wirelessly reports what it finds to a detector located in a pillow. A few times a day the user lies down on the pillow unit and presses a button to start sending the information for analysis.
Research has shown the information recorded by this tiny device can be very useful to heart failure specialists and allows us to make medication adjustments which may prevent new symptoms and help keep patients out of the hospital.
Therapeutic Devices
Most devices are actually both diagnostic and therapeutic. These incredibly advanced devices are able to detect a heart problem and take care of it. Some devices also have the ability to monitor lung water build up and provide heart failure specialists additional tools to help prevent deterioration and hospitalization.
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Implantable Cardiac Defibrillators (ICDs)
Heart failure increases the risk of developing abnormal heart rhythms which can be serious and possibly deadly. Implantable cardiac defibrillators (ICDs) are surgically placed in the upper chest area and connected to the heart with electrical leads. When a serious or life threatening arrhythmia is detected an electrical shock is delivered from the device through the lead to the heart to stop it. ICDs are very effective and have saved many lives. Not everyone with heart failure needs an ICD. Your CHFCare Team will work with you and one of our electrophysiologists to determine if an ICD is the right option for you.
Cardiac Resynchronization Devices
Cardiac resynchronization therapy (CRT) device is similar to an ICD. In fact, in many patients one device does double duty as an ICD and as a resynchronization device. A damaged heart electrical system is not uncommon with heart failure. Resynchronization is needed when the heart is not pumping efficiently due to abnormal conduction of electrical activity which causes different parts of the heart to respond at different times. A CRT device bypasses the bad conduction system and simultaneously sends electrical power to all parts of the heart at the same time. CRT can improve heart function significantly and help reduce symptoms and hospitalizations, as well as improve survival.
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LEFT VENTRICULAR ASSIST DEVICE
Despite use of medications and devices, some people continue to progress to advanced heart failure. This is the end stage. The choices at this stage are limited. Some patients may qualify for a heart transplant based on their clinical status and other considerations. Other patients won’t do well with a heart transplantation and may benefit from a device to assist the heart with its pumping work.
A ventricular assist device (VAD) is a battery-operated, mechanical suction pump surgically implanted to help move blood from the heart to the rest of the body. These machine have become very advanced in recent years and can be lifesaving.
Ventricular assist device can be placed on the left side, on the right side or on both sides depending on how weak the heart is. Most commonly they are placed on the left side and are known as a left ventricular assist device or LVAD. LVADs are portable and patients can use them to live for years and maintain very good quality of life. are often used for weeks to months. Patients with LVADs can be discharged from the hospital and can maintain an acceptable quality of life.
