Devices for heart failure

Cardiac implantable electronic devices are advanced heart failure therapies, delivered by specialists, that require continuing management from a multidisciplinary team including physicians, cardiac physiologists and specialist nurses. Selected patients with persistent, severe left ventricular systolic dysfunction despite optimal medical therapy with renin-angiotensin-aldosterone system antagonists and appropriate β-adrenoceptor blockers may benefit from an implantable cardioverter-defibrillator to prevent sudden cardiac death. Patients in this category can also benefit from cardiac resynchronization therapy if they have a broad QRS duration on their resting ECG. In addition to prognostic therapies, diuretics are often required to improve symptoms related to congestion. Strategies to recognize decompensation and guide intervention are beneficial to the individual patient and the wider health economy. The recent introduction of an implantable pulmonary artery pressure monitoring system is an exciting development in this field.