Devices and intervention in heart failure.

1. • I have received honoraria and research
support from numerous pharmaceutical and
device companies.

4. Eur J of Heart Fail (2014) 16, 796–801

6. N Eng J Med 2004;351:16:1681-1684

7. Eur J of Heart Fail (2014) 16, 1223–1229

9. LV Remodeling Post MI and
Heart Failure
• Parachute: Ventricular Restoration
– Partitions the damaged muscle and reduces heart
wall stress
– Decreases LV volume and restores geometrical
shape
– Improves cardiac performance
Speaker
1Jhund and McMurray.
Heart Failure After Acute
MI. Circulation.
2008;118:2019-2021
2RESTORE Group. JACC
2004, Vol. 44, No. 7.

10. Eur J of Heart Fail (2014) 16, 1112–1119

12. Baroreflex Activation Therapy (BAT)
Application
• Stimulate bilaterally (2nd gen
unilaterally) carotid bodies
Hypothesis: BAT mimics increased BP resulting
in inhibition of sympathetic activity and
enhanced parasympathetic activity
• Clinical data suggest BAT reduces muscle
sympathetic nerve activity and improves HRV
Evidence
Carotid sinus
mechanoreceptors
Carotid sinus
nerves
Brainstem
cardiovascular
centers
Ach Ach

13. Eur J of Heart Fail (2014) 16, 977–983

15. Eur J of Heart Fail (2014) 16, 403–408

17. Eur J of Heart Fail (2014) 16, 1120–1124

19. Eur J of Heart Fail (2014) 16, 117–118

21. Eur J of Heart Fail (2015) 17, 135–143

22. PACE Primary
Endpoints
LVejectionfraction(%)
*P<0.001 vs. baseline, †P<0.05 vs. 1-year follow-up
Absolute difference of EF by 7%Absolute difference of EF by 7% at 1-year, andat 1-year, and
9.9% at 2-year9.9% at 2-year
RVA pacingRVA pacing
BiV pacing
LVend-systolicvolume
(ml)
*P<0.001 vs. baseline, †P<0.05 vs. 1-year follow-up
Absolute difference of LVESV by 8.1mlAbsolute difference of LVESV by 8.1ml at 1-year,at 1-year,
and 13.0 ml at 2-yearand 13.0 ml at 2-year
EF LVESV

24. Eur J of Heart Fail (2014) 16, 1199–1205

27. EurJ of Heart Fail (2014) 16, 1323–1330

29. Eur J of Heart Fail (2014) 16, 802–809

31. Eur J of Heart Fail (2014) 16, 419–425

32. Thanks for your attention

33. BACKUP

35. Eur J of Heart Fail (2014) 16, 1104–1111

37. Eur J of Heart Fail (2014) 16, 227–234

39. Eur J of Heart Fail (2014) 16, 1206–1213

40. Eur J of Heart Fail (2014) 16, 1206–1213

42. Eur J of Heart Fail (2014) 16, 1214–1222

45. ”It is a fact of life that any discourse, on
any subject, whatever the occasion and
whatever the status of the speaker, will
always please if it is five minutes shorter
than people expect.”
Paul Johnson

46. Ventricular Volumes are Strongest Predictors
of Survival%PatientsSurviving
605 male patients, <60 years old, assessed 1-2 months
post-MI and followed for 78 months (mean)
White HD, et al. Circulation 1987;76:44-51.