Integration of implantable device therapy in patients with heart failure. A clinical consensus statement from the Heart Failure Association (HFA) and European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC)
Mullens W. Dauw J. Gustafsson F. Mebazaa A. Steffel J. Witte K.K. Delgado V. Linde C. Vernooy K. Anker S.D. Chioncel O. Milicic D. Hasenfuß G. Ponikowski P. von Bardeleben R.S. Koehler F. Ruschitzka F. Damman K. Schwammenthal E. Testani J.M. Zannad F. Böhm M. Cowie M.R. Dickstein K. Jaarsma T. Filippatos G. Volterrani M. Thum T. Adamopoulos S. Cohen-Solal A. Moura B. Rakisheva A. Ristic A. Bayes-Genis A. Van Linthout S. Tocchetti C.G. Savarese G. Skouri H. Adamo M. Amir O. Yilmaz M.B. Simpson M. Tokmakova M. González A. Piepoli M. Seferovic P. Metra M. Coats A.J.S. Rosano G.M.C.
February 2024John Wiley and Sons Ltd
European Journal of Heart Failure
2024#26Issue 2483 - 501 pp.
Implantable devices form an integral part of the management of patients with heart failure (HF) and provide adjunctive therapies in addition to cornerstone drug treatment. Although the number of these devices is growing, only few are supported by robust evidence. Current devices aim to improve haemodynamics, improve reverse remodelling, or provide electrical therapy. A number of these devices have guideline recommendations and some have been shown to improve outcomes such as cardiac resynchronization therapy, implantable cardioverter-defibrillators and long-term mechanical support. For others, more evidence is still needed before large-scale implementation can be strongly advised. Of note, devices and drugs can work synergistically in HF as improved disease control with devices can allow for further optimization of drug therapy. Therefore, some devices might already be considered early in the disease trajectory of HF patients, while others might only be reserved for advanced HF. As such, device therapy should be integrated into HF care programmes. Unfortunately, implementation of devices, including those with the greatest evidence, in clinical care pathways is still suboptimal. This clinical consensus document of the Heart Failure Association (HFA) and European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC) describes the physiological rationale behind device-provided therapy and also device-guided management, offers an overview of current implantable device options recommended by the guidelines and proposes a new integrated model of device therapy as a part of HF care.
Device therapy , Heart failure
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Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
UHasselt, Biomedical Research Institute, Faculty of Medicine and Life Sciences, LCRC, Diepenbeek, Belgium
UHasselt, Doctoral School for Medicine and Life Sciences, LCRC, Diepenbeek, Belgium
The Heart Center, University Hospital of Copenhagen, Copenhagen, Denmark
Université de Paris, UMR Inserm – MASCOT; APHP Saint Louis Lariboisière University Hospitals, Department of Anesthesia-Burn-Critical Care, Paris, France
Hirslanden Heart Clinic and University of Zurich, Zurich, Switzerland
Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
Hospital University Germans Trias i Pujol, Fundació Institut dInvestigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
Karolinska Institutet, Department of Medicine, Karolinska University Hospital, Heart Vascular and Neurology Theme, Stockholm, Sweden
Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
Division of Cardiology and Metabolism, Department of Cardiology (CVK) and Berlin-Brandenburg Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’, University of Medicine Carol Davila, Bucharest, Romania
University of Zagreb School of Medicine, Zagreb, Croatia
University Medical Center Göttingen (UMG), Department of Cardiology and Pneumology, German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
Department of Cardiology, University Medical Center Mainz, Mainz, Germany
Medical Department, Division of Cardiology and Angiology, Centre for Cardiovascular Telemedicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
Clinic of Cardiology, University Heart Centre, University Hospital, Zurich, Switzerland
University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, Netherlands
Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Ramat Aviv, Israel
Division of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States
Centre dInvestigations Cliniques Plurithématique 14-33, Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Université de Lorraine, Nancy, France
Universitatsklinikum des Saarlandes, Klinik fur Innere Medizin III, Saarland University, Kardiologie, Angiologie und Internistische Intensivmedizin, Homburg, Germany
Royal Brompton Hospital, Guys & St Thomas NHS Foundation Trust, and School of Cardiovascular Medicine and Sciences, Faculty of Lifesciences & Medicine, Kings College London, London, United Kingdom
University of Bergen, Bergen, Norway; and Stavanger University Hospital, Stavanger, Norway
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
National and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon, Athens, Greece
IRCCS San Raffaele, Rome, Italy
Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany and Fraunhofer institute for Toxicology and Experimental Medicine, Hannover, Germany
Heart Failure and Transplant Unit, Onassis Cardiac Surgery Centre, Athens, Greece
Department of Cardiology, University Hospital Lariboisière, AP-HP, Paris, France; INSERM UMR-S 942, MASCOT, Université Paris Cité, Paris, France
Armed Forces Hospital, Porto, and Faculty of Medicine of Porto, Porto, Portugal
Cardiology Department, Scientific Institute of Cardiology and Internal Medicine, Almaty, Kazakhstan
Universi Faculty of Medicine, University of Belgrade, and Serbian Academy of Arts and Sciences, Belgrade, Serbia
Heart Institute, Hospital Universitari Germans Trias i Pujol, CIBERCV, Badalona, Spain
Berlin Institute of Health (BIH) at Charité - Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany; German Center for Cardiovascular Research (DZHK), Partner site Berlin, Berlin, Germany
Cardio-Oncology Unit, Department of Translational Medical Sciences (DISMET); Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center for Clinical and Translational Research (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA); Federico II University, Naples, Italy
Department of Medicine, Karolinska Institutet and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
Division of Cardiology, Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon
Cardiology and Cardiac Catheterization Laboratory, ASST Spedali Civili Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel
Dokuz Eylul University, Konak, Turkey
NHS Greater Glasgow & Clyde, Glasgow, United Kingdom
Medical University of Plovdiv, Plovdiv, Bulgaria
Program of Cardiovascular Diseases, CIMA Universidad de Navarra, and IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
Clinical Cardiac Unit, Policlinico San Donato, University of Milan, Milan, Italy
Warwick Medical School, University of Warwick, Coventry, United Kingdom
St Georges University Medical School of London, London, United Kingdom
Ziekenhuis Oost-Limburg
UHasselt
UHasselt
The Heart Center
Université de Paris
Hirslanden Heart Clinic and University of Zurich
Department of Internal Medicine I
Department of Cardiology
Hospital University Germans Trias i Pujol
Karolinska Institutet
Department of Cardiology
Division of Cardiology and Metabolism
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’
University of Zagreb School of Medicine
University Medical Center Göttingen (UMG)
Department of Heart Diseases
Department of Cardiology
Medical Department
Clinic of Cardiology
University of Groningen
Leviev Cardiothoracic and Vascular Center
Division of Cardiovascular Medicine
Centre dInvestigations Cliniques Plurithématique 14-33
Universitatsklinikum des Saarlandes
Royal Brompton Hospital
University of Bergen
Julius Center for Health Sciences and Primary Care
National and Kapodistrian University of Athens School of Medicine
IRCCS San Raffaele
Institute of Molecular and Translational Therapeutic Strategies (IMTTS)
Heart Failure and Transplant Unit
Department of Cardiology
Armed Forces Hospital
Cardiology Department
Universi Faculty of Medicine
Heart Institute
Berlin Institute of Health (BIH) at Charité - Universitätmedizin Berlin
Cardio-Oncology Unit
Department of Medicine
Division of Cardiology
Cardiology and Cardiac Catheterization Laboratory
Hadassah Medical Center
Dokuz Eylul University
NHS Greater Glasgow & Clyde
Medical University of Plovdiv
Program of Cardiovascular Diseases
Clinical Cardiac Unit
Warwick Medical School
St Georges University Medical School of London
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