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Review
. 2024 Oct 18:11:1388232.
doi: 10.3389/fcvm.2024.1388232. eCollection 2024.

Device therapies for heart failure with reduced ejection fraction: a new era

Rohit Mody  1 , Abha Bajaj Nee Sheth  2 , Debabrata Dash  3 , Bhavya Mody  4 , Ankit Agrawal  5 , Inderjeet Singh Monga  6 , Lakshay Rastogi  4 , Amit Munjal  7
Affiliations
Review

Device therapies for heart failure with reduced ejection fraction: a new era

Rohit Mody et al. Front Cardiovasc Med. .

Abstract

Even with significant advancements in the treatment modalities for patients with heart failure (HF), the rates of morbidity and mortality associated with HF are still high. Various therapeutic interventions, including cardiac resynchronization therapy, Implantable Cardiovascular-Defibrillators, and left ventricular assist devices, are used for HF management. Currently, more research and developments are required to identify different treatment modalities to reduce hospitalization rates and improve the quality of life of patients with HF. In relation to this, various non-valvular catheter-based therapies have been recently developed for managing chronic HF. These devices target the pathophysiological processes involved in HF development including neurohumoral activation, congestion, and left ventricular remodeling. The present review article aimed to discuss the major transcatheter devices used in managing chronic HF. The rationale and current clinical developmental stages of these interventions will also be addressed in this review.

Keywords: cardiac resynchronization; congestive heart failure; device; implantable catheters; minimally invasive surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Therapeutic device options for the management of patients with HFrEF. †BAT, baroreflex activation; ICD, implantable cardioverter–defibrillator; CCM, cardiac contractility modulation; SCD, sudden cardiac death; CRT, cardiac resynchronization therapy.
Figure 2
Figure 2
Devices approved by FDA to be used in HF along with their level of evidence according to NYHA class and LVEF. †FDA, Food and Drug Administration; HF, heart failure; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; HFrEF, heart failure reduced ejection fraction; TEER, transcatheter edge-to-edge mitral valve repair; BAT, baroreflex activation therapy; CCM, cardiac contractility modulation.
Figure 3
Figure 3
Optimizer cardiac contractility modulation system used for heart failure management.
Figure 4
Figure 4
Device-based algorithm for the management of patients with heart failure and reduced ejection fraction. Devices approved by FDA to be used in HF along with their level of evidence according to NYHA class and LVEF. †FDA, Food and Drug Administration; HF, heart failure; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; HFrEF, heart failure reduced ejection fraction; TEER, transcatheter edge-to-edge mitral valve repair; BAT, baroreflex activation therapy; CCM, cardiac contractility modulation.
Figure 5
Figure 5
Level of evidence for clinical use of LVADs according to class of recommendation and LOE to clinical strategies, interventions, treatments, or diagnostic testing in patient care (updated May 2019). †LVAD, left ventricular assist device; LOE, level of evidence.
Figure 6
Figure 6
The workflow of CARMAT-total artificial heart.
Figure 7
Figure 7
Upcoming devices for HF and their level of evidence for clinical use according to class of recommendation and LOE to clinical strategies, interventions, treatments, or diagnostic testing in patient care (updated May 2019).†HF, heart failure; LOE, level of evidence.
Figure 8
Figure 8
Implantable sensors for hemodynamic monitoring: (A) Chronicle, (B) CardioMEMS, (C) Cordella, (D) V-LAP, and (E) HeartPOD. †LAP, left atrial pressure.
Figure 9
Figure 9
Implantable left atrial decompression devices: (A) Corvia IASD, (B) V-wave, (C) TASS, and (D) AFR. †IASD, inter-atrial shunt device; TASS, transcatheter atrial shunt system; AFR, atrial flow regulator.
Figure 10
Figure 10
Left ventricular restoration devices: (A) AccuClinch ventricular restoration system, (B) papillary muscle sling, and (C) Revivent TC system.
Figure 11
Figure 11
Transcatheter devices used for neuromodulation: (A) Barostim Neo, (B) Harmony system, (C) Vitara, and (D) Satera ablation system.
Figure 12
Figure 12
Transcatheter devices used for the management of acute cardiorenal syndrome: (A) Aortix percutaneous mechanical circulatory support system, (B) Reitan catheter pump, (C) secondary heart assist device, (D) Doraya renal flow regulator, (E) preCARDIA system, (F) TRVD system, (G) reprieve system, and (H) CPNS. †TRVD, transcatheter renal venous decongestion; CPNS, cardiac pulmonary nerve stimulation.
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