Many cardiac medications will remain important in managing the patient’s symptoms even in the advanced stages of cardiac failure, e.g. furosemide for breathlessness secondary to fluid overload.
Certain cardiac interventions may improve quality of life in cardiac failure even in advanced disease.
For patients who have an implantable device, it is important to establish whether it is purely a pacemaker or a device which includes defibrillator function.
Cardiac resynchronization therapy (CRT)
Also known as the biventricular pacemaker, may be beneficial in carefully selected patients to correct cardiac ‘dyssynchrony’ (uncoordinated and inefficient pumping of the right and left ventricles).
CRT pacing therapy in advanced cardiac failure can improve:
• quality of life
Types of device include:
• CRT–P (pacing mode)
• CRT–D (pacing and defibrillator function)
Some ICDs (Implantable Cardioverter Defibrillators) function purely as defibrillators.
ICDs reduce sudden cardiac death in patients with cardiac failure in those surviving a ventricular arrhythmic event (secondary prevention) and for primary prevention.