Devices for heart failure

Cardiac devices play an important role in the treatment of heart failure. Implantable cardioverter defibrillators prevent sudden cardiac death from ventricular arrhythmias and prolong life in specific subgroups of patients. Cardiac resynchronization pacing can overcome the dyssynchrony resulting from left bundle branch block and improve cardiac output in the failing heart. Both of these therapies are appropriate for carefully selected patients based on randomized controlled trial data. A new advance is the introduction of the subcutaneous ICD. The benefits and challenges of device therapy and current guidelines are discussed in this article.