Role and Indications for Device Therapies in Heart Failure: Condensed Summary

Over the past decade, the substantial benefits associated with current guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) have been brought into the light, as emphasized in a recent publication from our institution. Despite these advances, device therapy continues to hold an important place in treating heart failure (HF), both for left ventricular (LV) remodeling (and associated prognosis) as well as for preventing sudden cardiac death (SCD). Cardiac resynchronization therapy (CRT) is a key intervention in heart failure (HF) management, particularly for patients with left bundle branch block (LBBB), which is observed in 15–25% of patients with HF, and is associated with reduced left ventricular function. CRT helps in correcting dyssynchronous ventricular contraction leading to impaired cardiac output. Although less prevalent, right bundle branch block (RBBB) and nonspecific interventricular conduction delay (IVCD) are also associated with adverse remodelling, including increased right ventricular volumes and reduced function.