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MedTech Outlook | Thursday, December 29, 2022
Heart failure patients are increasingly experiencing heart failure, and clinical challenges in managing advanced heart failure conditions have made implantable devices an essential treatment method.
FREMONT, CA: In eligible patients, the current standard of care for heart failure (HF) includes a combination of guideline-directed medical therapy and device-based interventions. However, many patients with HF undergo gradual worsening, necessitating additional intervention.
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Due to the lack of effective treatment choices for more than 75 percent of new heart failure patients each year, about 200,000 patients wait for their condition to worsen as their health and quality of life decline. While numerous advancements have been made over the years, it is becoming increasingly evident that medical devices, such as mechanical circulatory support (MCS), will improve HF management and patient outcomes.
New device innovations coupled with individualized medical management will play a vital role in extending and saving patient lives while enhancing their quality of life.
THERAPIES FOR IMPLANTABLE HEART DEVICES
Due to the significant increase in patients with heart failure and the difficulties in managing severe heart failure syndromes in clinical practice, implanted device therapies have become an essential therapy technique. Patients with ventricular dyssynchrony, a disorder of the heart rhythm, are treated with cardiac resynchronization therapy (CRT) as a standard of care. In contrast, hemodynamically compromised patients, i.e., those whose heart is unable to pump and fill with blood adequately, are not candidates for CRT and are treated with MCS when indicated.
Cardiac resynchronization therapy employs an implantable biventricular pacemaker (CRT-P) to synchronize contractions and enhance cardiac output by sending electric signals to the heart's left and right ventricles. The CRT system comprises an implantable pulse generator and insulated lead wires that are supposed to give electrical charges to the heart and restore the normal temporal pattern of the heartbeat. CRTs are a commendable therapeutic option, but they are restricted to individuals whose HF is exacerbated by electrical dyssynchrony, often due to a left bundle branch block.
Today's CRT devices combine pacing and implanted cardioverter-defibrillator capabilities (ICD). An ICD is a tiny device implanted in the chest that continuously monitors the heart's rhythm, identifying irregular heartbeats. Arrhythmias that cause abrupt cardiac arrest or dangerously irregular heart rhythms are treated with internal electric shocks (CRT-D).
Treatment of severe heart rhythm abnormalities based on radio-frequency ablation provides further hope for comfort and survival in addition to implantable cardioverter defibrillators (ICDs).
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