Heart Failure (HF) treatment requires a multifaceted approach. It is usually a combination of nonpharmacologic, pharmacologic, and possibly invasive strategies to limit and reverse the symptoms of heart failure. Treatment of heart failure depends on its cause. The overall goals of treatment are to correct underlying pathology, to relieve symptoms, to prevent a worsening of the condition, to reduce the frequency of hospitalizations, and to prolong life.
Nonpharmacologic therapies refer to dietary changes and restrictions such as sodium and fluid restriction and management of physical activity.
Pharmacologic therapies include the use of diuretics, vasodilators, inotropic agents, anticoagulants, angiotensin-converting enzyme inhibitors, beta-blockers, or aldosterone inhibitors (all drugs that block the body’s neurohormonal system),
Invasive therapies for heart failure include electrophysiologic interventions. Patients with prolonged QRS duration and dyssynchronous contractions (which occur in about 30% of cases) receive additional Cardiac Resynchronization Therapy (CRT), a special type of pacemaker or ICD, on top of medications.
Most patients with heart failure however, have normal QRS duration and do not benefit from CRT treatment. In fact, two-fifths of HF patients who receive cardiac resynchronization therapy (CRT) aren’t benefiting clinically from the device therapy because the guidelines-specified electrocardiographic criteria for eligibility are too broad, according to the authors of a new meta-analysis of the major CRT trials.
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