Heart Failure - When drugs do not work

Advanced heart failure is a growing issue. Existing pharmacological strategies increase the survival rates of acute heart failure patients, providing a growing source of patients with advanced disease. In view of long waiting lists for heart transplantation and the growing lack of donors, cardiac resynchronization and mechanical circulatory support devices have demonstrated promising results.

With no new drug therapies addressing advanced heart failure and existing pharmacological strategies failing to compensate a weakening heart, alternative, non-pharmacological solutions have to be found. In view of long waiting lists for heart transplantation and the growing shortage of donor hearts, the focus of treatment must shift onto devices.

Ventricular dyssynchrony is a well recognized problem in advanced stages of heart failure. Clinical trials investigating ventricular dyssynchrony cardiac resynchronization have demonstrated promising results. However, this technology provides only temporary, symptomatic relief and neither cures nor fully stops the progression of the disease.

In light of the growing shortage of donor hearts and failing pharmacological strategies, an artificial mechanical heart has been a long sought-after technology. Although the developments started decades ago, a fully implantable total artificial heart is still at the concept stage, with many years of research and development yet to come.

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