Cardiac Rhythm Devices in Heart Failure with Reduced Ejection Fraction – Role, Timing, and Optimal Use in Contemporary Practice. <i>European Journal of Heart Failure</i> Expert Consensus Document
Guidelines for management of heart failure with reduced ejection fraction (HFrEF) emphasize personalized care, patient engagement, and shared decision-making. Medications and cardiac rhythm management (CRM) devices are recommended with a high level of evidence. However, there are significant disparities: patients who could benefit from devices are frequently referred too late or not at all. Misconceptions about device therapy and the notion that the needs of patients (especially the prevention of sudden cardiac death) can now be met by expanding drug therapies may play a role in these disparities. This state-of-the-art review is produced by members of the DIRECT HF initiative, a patient-centred, expert-led educational programme that aims to advance guideline-directed use of CRM devices in patients with HFrEF. This review discusses the latest evidence on the role of CRM devices in reducing HFrEF mortality and morbidity, and provides practical guidance on patient referral, device selection, implant timing and patient-centred follow-up.
Authors
- Gianluigi Savarese (ORCID: https://orcid.org/0000-0001-7732-0887)
- Antoni Bayés‐Genís (ORCID: https://orcid.org/0000-0002-3044-197X)
- Biykem Bozkurt (ORCID: https://orcid.org/0000-0002-6362-0253)
- Loreena Hill (ORCID: https://orcid.org/0000-0001-5232-0936)
- Cecilia M. Linde (ORCID: https://orcid.org/0000-0002-9039-6023)
- Koichiro Kinugawa (ORCID: https://orcid.org/0000-0003-0009-8477)
- William T. Abraham (ORCID: https://orcid.org/0000-0003-4805-1037)
- Giuseppe Rosano (ORCID: https://orcid.org/0000-0002-6868-4248)
- Javed Butler (ORCID: https://orcid.org/0000-0003-4267-6933)
- Alexandre Mebazaa (ORCID: https://orcid.org/0000-0001-8715-7753)
- Shelley R. Zieroth (ORCID: https://orcid.org/0000-0002-6145-9814)
- Wilfried Müllens (ORCID: https://orcid.org/0000-0001-9995-8590)
- Naoki Sato (ORCID: https://orcid.org/0000-0002-5550-0083)
- Andrea Russo (ORCID: https://orcid.org/0000-0003-2475-0925)
- Michael Böhm (ORCID: https://orcid.org/0000-0003-1208-8647)
- C. Leclercq
Institutions
- Universitat Autònoma de Barcelona (ES)
- Queen's University Belfast (GB)
- Vita-Salute San Raffaele University (IT)
- Inserm (FR)
- St George's, University of London (GB)
- Baylor College of Medicine (US)
- Università degli studi di Cassino e del Lazio Meridionale (IT)
- Université Paris Cité (FR)
- Karolinska Institutet (SE)
- San Raffaele University of Rome (IT)
- Université Rennes 2 (FR)
- University of Mississippi (US)
- Cooper Medical School of Rowan University (US)
- Sorbonne Paris Cité (FR)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (ES)
- Assistance Publique – Hôpitaux de Paris (FR)
- Baylor Medical Center at Garland (US)
- IRCCS Ospedale San Raffaele (IT)
- Noguchi Hospital (JP)
- Ziekenhuis Oost-Limburg (BE)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- University of Toyama (JP)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- City St George's, University of London (GB)
- University of Manitoba (CA)
- The Ohio State University (US)
- Université de Rennes (FR)
- Hasselt University (BE)
- Saarland University (DE)
Publication Details
- Journal
- European Journal of Heart Failure
- Published
- 2025-04-09
- DOI
- https://doi.org/10.1002/ejhf.3641
- Citations
- 4
- Primary Topic
- Cardiac pacing and defibrillation studies
- Type
- article
- Field-Weighted Citation Impact
- 5.55