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Device therapy: which devices and for whom? 

Device therapy: which devices and for whom?
Chapter:
Device therapy: which devices and for whom?
Author(s):

Roy S. Gardner

, Theresa A. McDonagh

, and Niki L. Walker

DOI:
10.1093/med/9780199674152.003.0006
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date: 22 February 2020

The majority of patients with heart failure stabilize or improve with pharmacological therapy. Device therapy in heart failure addresses two potential consequences of left ventricular dysfunction, namely malignant ventricular arrhythmias that can lead to sudden cardiac death (SCD), and ventricular dyssynchrony. These two phenomena can coexist in the CHF patient. Cardiac resynchronization therapy (CRT) has a clear role in selected patients with advanced heart failure who remain symptomatic despite maximum tolerated pharmacological therapy. Implantable cardiac defibrillators (ICD) have also been shown to reduce arrhythmic deaths in both ischaemic and non-ischaemic cardiomyopathy. CRT can be combined with ICD functions (Cardiac Resynchronization Therapy-Defibrillator: CRT-D) to achieve the benefits of both devices. This chapter presents the evidence for the use of these devices, and summarizes the latest recommendations for the clinical guidelines.

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