Heart Failure Management
Congestive Heart Failure (CHF) affects more than 6 million Americans and the cost of heart failure management in the U.S. is more than $30 billion / year! CHF can be due to systolic dysfunction -- weak heart pumping function that can be caused by coronary artery disease including heart attacks or may be "non-ischemic" in origin due to viral infections, excessive alcohol use or chemotherapy. CHF can also be "diastolic" in which case the heart pumping function is normal but the heart muscle is thickened and too stiff which results in fluid backing up into the lungs experienced as shortness of breath. Another cause of heart failure is valvular heart disease, either valvular leakage ("regurgitation") or restricted opening of the valve ("stenosis") such as mitral valve regurgitation or aortic stenosis.
Medical Therapy of CHF
Medical therapy is the cornerstone of CHF management. OHVI cardiologists provide our CHF patients with medications proven to reduce heart failure symptoms and reduce mortality. Such medications include beta-blockers, ACE-inhbitors, angiotensin receptor blockers, diuretics, aldosterone receptor antagonists, and the more recently introduced angiotensin receptor neprilysin inhibitors.
Patients with heart failure due to systolic dysfunction (low ejection fraction <35%) are at increased risk of sudden cardiac death due to arrhythmias such ventricular tachycardia and ventricular fibrillation. OHVI cardiologists specialize in the implantation of automatic implantable cardiodefibrillators (AICD). These devices are similar to pacemakers but also have the ability to provide a life-saving electric shock to the heart to prevent sudden death in the event of a life-threatening arrhythmia. Sophisticated bi-ventricular defibrillators can not only reduce risk of sudden death but can actually increase heart pumping function and improve quality of life, as well, by "re-synchronizing" ventricular contraction in patients with conduction disease evident on EKG as a "bundle branch block".
OHVI is on the cutting edge of heart failure management by offering a dramatic new technology to our patients -- the CVRx BaroStim device! For more information, click here: https://www.cvrx.com/barostim-therapy-for-heart-failure
This novel device uses a specialized lead to stimulate the carotid baroreceptor in the neck. The lead is placed using a minor surgical procedure and is attached to a pacemaker-like device under the skin of the chest. Stimulation of the baroreceptor works by changing vascular tone in a favorable way.
Barostim Therapy is the only treatment that reduces sympathetic activity while restoring parasympathetic activity. This results in the restoration of autonomic balance, which can improve cardiac structure and function... resulting in an improvement in heart failure symptoms!
Impulse Dynamics Cardiac Contractility Modulation
The Optimizer Smart System is a breakthrough technology now being offered to OHVI patients with moderate to severe congestive heart failure. The device utilizes two pacemaker leads to electrically stimulate (but not pace) the heart which, over time, results in improvement in the strength of the heart's pumping function. Patients with this device experience improved quality of life including the ability to walk farther without shortness of breath. CCM is currently approved for patients in normal sinus rhythm (or only occasional atrial fibrillation...) with ejection fraction of 25-45%. The implant procedure is quite similar to having a pacemaker placed and is safe and now FDA-approved! For more information, visit https://impulse-dynamics.com/ or ask your cardiologist!
Research and Advanced Therapies
As a leader in heart failure management, OHVI participates in numerous clinical trials that offer our patients "state of the art" options for management of advanced CHF. OHVI also works closely with the Advanced Heart Failure team at Advent Health offering every possible option to our sickest patients including outpatient inotrope infusion therapy, left ventricular assist devices ("LVAD") and even cardiac transplantation.