Heart failure clinics
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Heart failure clinics · Jan 2009
ReviewSpecial cases in acute heart failure syndromes: atrial fibrillation and wide complex tachycardia.
Hospitalization for acute heart failure syndromes (AHFS) results in substantial in-hospital and postdischarge morbidity and mortality. Management of AHFS presents significant challenges, given the heterogeneity of the patient population and the differing etiologies underlying why patients present with acute decompensation. ⋯ Compounding this challenge is the paucity of evidence on which to base early management. General principles for the management of atrial fibrillation and wide complex tachycardia in the setting of emergency department AHFS are discussed.
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Heart failure clinics · Jul 2007
ReviewSymptomatic relief: left ventricular assist devices versus resynchronization therapy.
In patients who have end-stage heart failure, medical therapy is of limited use, and heart transplantation is frequently not an option because of the shortage of donor hearts. Two new treatment options, left ventricular assist devices (LVADs) and implantable cardiac resynchronization therapy (CRT) devices, can improve survival and quality of life in patients who have heart failure. Both types of devices are easy to implant. ⋯ Therefore, methods must be devised to identify patients who have heart failure who are likely to benefit from these devices. Data suggest that early LVAD implantation, before end-stage heart failure develops, is critical to slowing or reversing disease progression. Similarly, in indicated patients who have less advanced disease, CRT may be particularly beneficial.