Skip to main content

Advertisement

SpringerLink
Log in

Updates on Device-Based Therapies for Patients with Heart Failure

  • Clinical Trials (J. Butler, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Heart failure is a growing epidemic. Optimal medical therapy remains the cornerstone of heart failure management but device-based therapies have been shown to contribute to morbidity and mortality reduction.

Recent Findings

Multiple investigational trials had been conducted in the past decade that helped us better understand and manage heart failure. In this manuscript, we will discuss the major device related trials of year 2017 in the fields of defibrillators, hemodynamic monitoring, remote monitoring, autonomic nervous system modulation, ventricular assist devices, and device-based valvular heart disease management.

Summary

Further research and trials in device-based therapies are needed to explore their long-term reduction in mortality and morbidity along with cost-effectiveness analyses in patients living with heart failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Hunt SA, Abraham WT, Chin MH, et al. 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults a report of the American College of Cardiology foundation/American Heart Association task force on practice guidelines developed in collaboration with the international society for heart and lung transplantation. J Am Coll Cardiol. 2009;53:e1–e90.

    Article  PubMed  Google Scholar 

  2. Askoxylakis V, Thieke C, Pleger ST, Most P, Tanner J, Lindel K, et al. Long-term survival of cancer patients compared to heart failure and stroke: a systematic review. BMC Cancer. 2010;10:105.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ross JS, Chen J, Lin Z, Bueno H, Curtis JP, Keenan PS, et al. Recent national trends in readmission rates after heart failure hospitalizations. Circ Heart Fail. 2010;3:97–103.

    Article  PubMed  Google Scholar 

  4. Hummel SL, Pauli NP, Krumholz HM, Wang Y, Chen J, Normand SL, et al. Thirty-day outcomes in Medicare patients with heart failure at heart transplant centers. Circ Heart Fail. 2010;3:244–52.

    Article  PubMed  Google Scholar 

  5. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. American Heart Association advocacy coordinating committee; council on arteriosclerosis, thrombosis and vascular biology; council on cardiovascular radiology and intervention; council on clinical cardiology; council on epidemiology and prevention; stroke council. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6:606–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Dunlay SM, Shah ND, Shi Q, Morlan B, VanHouten H, Long KH, et al. Lifetime costs of medical care after heart failure diagnosis. Circ Cardiovasc Qual Outcomes. 2011;4:68–75.

    Article  PubMed  Google Scholar 

  7. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure. J Am Coll Cardiol. 2013;62(16):e147–239.

    Article  PubMed  Google Scholar 

  8. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary: a report of the American College of Cardiology / American Heart Association Task force on clinical practice guidelines and the Heart Rhythm Society. Circulation.

  9. Santharam S, Hudsmith L, Thorne S, Clift P, Marshall H, De Bono J. Long-term follow-up of implantable cardioverter-defibrillators in adult congenital heart disease patients: indications and outcomes. Europace. 2017;19:407–13.

    PubMed  Google Scholar 

  10. Vakil K, Duval S, Cogswell R, Eckman P, Levy WC, Anand I, et al. Impact of implantable cardioverter-defibrillators on waitlist mortality among patients awaiting heart transplantation: an UNOS/OPTN analysis. JACC Clin Electrophysiol. 2017;3:33–40.

    Article  Google Scholar 

  11. Kusumoto FM, Bailey KR, Chaouki AS, Deshmukh AJ, Gautman S, Kim RJ, et al. Systematic review for the 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society [published online ahead of print October 30, 2017]. Circulation. 2017; https://doi.org/10.1161/CIR.0000000000000550.

  12. • Zeilter EP, Friedman DJ, Daubert JP, Al-Khatib SM, Solomon SD, Biton Y, et al. Multiple comorbidities and response to cardiac resynchronization therapy: MADIT-CRT long-term follow-up. J Am Coll Cardiol. 2017;69(19):2369–79. This work presents long-term follow up of the landmark MADIT-CRT study showing the benefit of CRT-D versus ICD alone despite comorbidities.

    Article  Google Scholar 

  13. Daimee UA, Biton Y, Aktas MK, Zannad F, Klein H, Szepietowska B, et al. Effect of significant weight change on inappropriate implantable cardioverter-defibrillator therapy. Pacing Clin Electrophysiol. 2017;40(1):9–16.

    Article  PubMed  Google Scholar 

  14. Skaf S, Thibault B, Khairy P, O’Meara E, Fortier A, Vakulenko HV, et al. Impact of left ventricular vs biventricular pacing on reverse remodeling: Insights from the evaluation of resynchronization therapy for heart failure (EARTH) trial. Can J Cardiol. 2017;33(10):1274–82.

    Article  PubMed  Google Scholar 

  15. Vidula H, Kutyifa V, McNitt S, Goldenberg J, Solomon SD, Moss AJ, et al. Long-term survival of patients with left bundle branch bock who are hypo-responders to cardiac resynchronization therapy. Am J Cardiol. 2017;120(5):825–30.

    Article  PubMed  Google Scholar 

  16. Biering-Sørensen T, Knappe D, Pouleur AC, Claggett B, Wang PJ, Moss AJ, et al. Regional longitudinal deformation improves prediction of ventricular tachyarrhythmias in patients with heart failure with reduced ejection fraction: A MADIT-CRT substudy. Circ Cardiovasc Imaging. 2017;10(1):e005096.

    Article  PubMed  Google Scholar 

  17. Elming MB, Nielsen JC, Haarbo J, Videbaek L, Korup E, Signorovitch J, et al. Age and outcomes of primary prevention implantable cardioverter-defibrillators in patients with non-ischemic systolic heart failure. Circulation. 2017;136(19):1772–80.

    Article  PubMed  Google Scholar 

  18. Nägele MP, Steffel J, Robertson M, Singh JP, Flammer AJ, Bax JJ, et al. Effect of cardiac resynchronization therapy in patients with diabetes randomized in EchoCRT. Eur J Heart Fail. 2017;19(1):80–7.

    Article  PubMed  Google Scholar 

  19. Sapp JL, Parkash R, Wells GA, Yetisir E, Gardner MJ, Healey JS, et al. Cardiac resynchronization therapy reduces ventricular arrhythmias in primary but not secondary prophylactic implantable cardioverter defibrillator patients: insight from the resynchronization in ambulatory heart failure trial. Circ Arrhythm Electrophysiol. 2017;10(2):e004875.

    Article  PubMed  Google Scholar 

  20. Gu M, Jin H, Hua W, Fan XH, Ding LG, Wang J, et al. Repetitive optimizing left ventricular pacing configurations with quadripolar leads improves response to cardiac resynchronization therapy: a single-center randomized clinical trial. Medicine (Baltimore). 2017;96(37):e8066.

    Article  Google Scholar 

  21. Reddy VY, Miller MA, Neuzil P, Soggard P, Butter C, Seifert M, et al. Cardiac resynchronization therapy with wireless left ventricular endocardial pacing: the SELECT-LV study. J Am Coll Cardiol. 2017;69(17):2119–29.

    Article  PubMed  Google Scholar 

  22. Kis Z, Arany A, Gyori G, Mihalcz A, Kardos A, Foldesi C, et al. Long-term cerebral thromboembolic complications of transapical endocardial resynchronization therapy. J Interv Card Electrophysiol. 2017;48(2):113–20.

    Article  PubMed  Google Scholar 

  23. Gold MR, Aasbo JD, El-Chami MF, Niebauer M, Herre J, Prutkin JM, et al. Subcutaneous implantable cardioverter-defibrillator post-approval study: clinical characteristics and perioperative results. Heart Rhythm. 2017;14(1):146–1463.

    Google Scholar 

  24. Boriani G, Da Costa A, Quesada A, Ricci RP, Favale S, Boscolo G, et al. Effects of remote monitoring on clinical outcomes and use of healthcare resources in heart failure patients with biventricular defibrillators: results of the MORE-CARE multicenter randomized controlled trial. Eur J Heart Fail. 2017;19(3):416–25.

    Article  PubMed  Google Scholar 

  25. Boehmer JP, Hariharan R, Devecchi FG, Smith AL, Molon G, Capucci A, et al. A multisensor algorithm predicts heart failure events in patients with implantable devices: results from the MultiSENSE study. JACC Heart Fail. 2017;5(3):216–25.

    Article  PubMed  Google Scholar 

  26. Adamson PB, Ginn G, Anker SD, Bourge RC, Abraham WT. Remote haemodynamic-guided care for patients with chronic heart failure: a meta-analysis of completed trials. Eur J Heart Fail. 2017;19:426–33.

    Article  PubMed  Google Scholar 

  27. • Givertz MM, Stevenson LW, Costanzo MR, Bourge RC, Bauman JG, Ginn G, et al. Pulmonary artery pressure-guided management of patients with heart failure and reduced ejection fraction. J Am Coll Cardiol. 2017;70(15):1875–86. This work highlights the utility of an implantable safe device that allows PA pressure monitoring to reduce HF hospitalizations.

    Article  PubMed  Google Scholar 

  28. Sandhu AT, Goldhaber-Fiebert JD, Owen DK, Turakhia MP, Kaiser DW, Heidenreich PA. Cost-effectiveness of implantable pulmonary artery pressure monitoring in chronic heart failure. JACC Heart Fail. 2016;4(5):368–75.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Feldman T, Mauri L, Kahwash R, Litwin S, Ricciardi MJ, van der Harst P, et al. A transcatheter interatrial shunt device for the treatment of heart failure with preserved ejection fraction (REDUCE LAP-HF I): a phase 2 randomized, sham-controlled trial. Circulation.

  30. Gronda E, Seravalle G, Brambilla G, Costantino G, Casini A, Alsheraei A, et al. Chronic baroreflex activation effects on sympathetic nerve traffic, baroreflex function, and cardiac hemodynamics in heart failure: a proof-of-concept study. Eur J Heart Fail. 2014;16:977–83.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Abraham WT, Zile MR, Weaver FA, Butter C, Ducharme A, Halbach M, et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction. J Am Coll Cardiol Heart Fail. 2015;3:487–96.

    Google Scholar 

  32. Naar J, Jaye D, Linde C, Neuzil P, Doskar P, Malek F, et al. Effects of spinal cord stimulation on cardiac sympathetic nerve activity in patients with heart failure. Pacing Clin Electrophysiol. 2017;40(5):504–13.

    Article  PubMed  Google Scholar 

  33. Kleemann T. Cardiac contractility modulation: a new form of therapy for patients with heart failure and narrow QRS complex? Herz. 2015;40:945–51.

    Article  CAS  PubMed  Google Scholar 

  34. Abi-Samra F, Gutterman D. Cardiac contractility modulation: a novel approach for the treatment of heart failure. Heart Fail Rev. 2016;21(6):645–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Muller D, Remppis A, Schauerte P, Schmidt-Schweda S, Burkhoff S, Rousso B, et al. Clinical effects of long-term cardiac contractility modulation (CCM) in subjects with heart failure caused by left ventricular systolic dysfunction. Clin Res Cardiol. 2017;106(11):893–904.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Liu X, Yang HJ, Ping HQ, Qiu S, Shi S, Yang B. The safety and efficacy of cardiac contractility modulation in heart failure: a meta-analysis of clinical trials. Herz. 2017;42(8):766–75.

    Article  CAS  PubMed  Google Scholar 

  37. Abraham WT, Aggarwal S, Prabhu SD, Cevere R, Pamboukian SV, Bank AJ, et al. Ambulatory extra-aortic counterpulsation in patients with moderate to severe chronic heart failure. JACC Heart Fail. 2014;2(5):526–33.

    Article  PubMed  Google Scholar 

  38. Schulz A, Krabatsch T, Schmitto JD, Hetzer R, Seifel M, Dohmen PM, et al. Preliminary results from the C-Pulse OPTIONS HF European multicenter post-market study. Med Sci Monit Basic Res. 2016;22:14–9.

    Article  PubMed  PubMed Central  Google Scholar 

  39. • Mehra M, Naka Y, Uriel N, Goldstein DJ, Cleveland JC Jr, Colombo PC, et al. A fully magnetically levitated circulatory pump for advanced heart failure. N Engl J Med. 2017;376:440–50. This work shows that Heartmate 3 was associated with higher survival rates free of reoperation due to the lack of suspected or confirmed pump thrombosis.

    Article  PubMed  Google Scholar 

  40. Rogers JG, Pagani FD, Tatooles AJ, Bhat G, Slaughter MS, Birks EJ, et al. Intrapericardial left ventricular assist device for advanced heart failure. N Engl J Med. 2017;376(5):451–60.

    Article  PubMed  Google Scholar 

  41. Maltais S, Kilic A, Nathan S, Keebler M, Emani S, Ransom J, et al. PREVENtion of HeartMate II thrombosis through clinical management: the PREVENT multi-center study. J Heart Lung Transplant. 2017;36(1):1–12.

    Article  PubMed  Google Scholar 

  42. Morshuis M, El-Banayosy A, Arusoglu L, Koerfer R, Hetzer R, Wieselthaler G, et al. European experience of DuraHeart magnetically levitated centrifugal left ventricular assist system. Eur J Cardiothorac Surg. 2009;35(6):1020–7.

    Article  PubMed  Google Scholar 

  43. Morshuis M, Schoenbrodt M, Nojiri C, Roefe D, Schulte-Eistrup S, Boergermann J, et al. DuraHeart magnetically levitated centrifugal left ventricular assist system for advanced heart failure patients. Expert Rev Med Devices. 2010;7(2):173–83.

    Article  PubMed  Google Scholar 

  44. Moazami N, Steffen RJ, Naka Y, Jorde U, Bailey S, Murali S, et al. Lessons learned from the first fully magnetically levitated centrifugal LVAD trial in the United States: the DuraHeart trial. Ann Thorac Surg. 2014;98(2):541–7.

    Article  PubMed  Google Scholar 

  45. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;63(22):e57–185.

    Article  PubMed  Google Scholar 

  46. Geis N, Raake P, Lewening M, Mereles D, Chorianopoulos E, Frankenstein L, et al. Percutaneous repair of mitral valve regurgitation in patients with severe heart failure: comparison with optimal medical treatment. Acta Cardiol. 2017;21:1–9.

    Article  Google Scholar 

  47. Vahl TP, Kodali SK, Leon MB. Transcatheter aortic valve replacement 2016: a modern-day “through the looking-glass” adventure. J Am Coll Cardiol. 2016;67:1472–87.

    Article  PubMed  Google Scholar 

  48. Lung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P, et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J. 2005;26:2714–20.

    Article  Google Scholar 

  49. Van der Boon RM, Nuis RJ, Van Meighem NM, Benitez LM, van Heuns RJ, Galema TW, et al. Clinical outcome following transcatheter aortic valve implantation in patients with impaired left ventricular systolic function. Catheter Cardiovasc Interv. 2012;79:702–10.

    Article  PubMed  Google Scholar 

  50. Baron SJ, Arnold SV, Herrmann HC, Holmes DR Jr, Szeto WY, Allen KB, et al. Impact of ejection fraction and aortic valve gradient on outcomes of transcatheter aortic valve replacement. J Am Coll Cardiol. 2016;67:2349–58.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Spitzer E, Van Mieghem NM, Pibarot P, Hahn RT, Kodali S, Maurer MS, et al. Rationale and design of the transcatheter aortic valve replacement to unload the left ventricle in patients with advanced heart failure (TAVR UNLOAD) trial. Am Heart J. 2016;182:80–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, 30 N. 1900E, Room 4A100, Salt Lake City, UT, 84112, USA

    Jad Al Danaf

  2. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Mississippi, 2500 N State Street L650, Jackson, MS, 39216, USA

    Javed Butler

  3. Division of Cardiovascular Medicine, Department of Internal Medicine, Augusta University, 95 Collier Rd Suite 3000, Atlanta, GA, 30309, USA

    Amin Yehya

Authors
  1. Jad Al Danaf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Javed Butler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amin Yehya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jad Al Danaf.

Ethics declarations

Conflict of Interest

Jad Al Danaf and Amin Yehya declare no conflicts of interest.

Javed Butler has received research support from the National Institutes of Health, PCORI and the European Union; and serves as a consultant for Amgen, Array, Astra Zeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squib, CVRx, G3 Pharmacautical, Innolife, Janssen, Luitpold, Medtronic, Merck, Novartis, Relypsa, StealthPeptide, SC Pharma, Vifor, and ZS Pharma.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Clinical Trials

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al Danaf, J., Butler, J. & Yehya, A. Updates on Device-Based Therapies for Patients with Heart Failure. Curr Heart Fail Rep 15, 53–60 (2018). https://doi.org/10.1007/s11897-018-0384-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11897-018-0384-x

Keywords

Search

Navigation