Language
English
Publication Date
7-1-2025
Journal
European Journal of Heart Failure
DOI
10.1002/ejhf.3641
PMID
40204670
PMCID
PMC12370598
PubMedCentral® Posted Date
4-9-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Guidelines for management of heart failure with reduced ejection fraction (HFrEF) emphasize personalized care, patient engagement, and shared decision-making. Medications and cardiac rhythm management (CRM) devices are recommended with a high level of evidence. However, there are significant disparities: patients who could benefit from devices are frequently referred too late or not at all. Misconceptions about device therapy and the notion that the needs of patients (especially the prevention of sudden cardiac death) can now be met by expanding drug therapies may play a role in these disparities. This state-of-the-art review is produced by members of the DIRECT HF initiative, a patient-centred, expert-led educational programme that aims to advance guideline-directed use of CRM devices in patients with HFrEF. This review discusses the latest evidence on the role of CRM devices in reducing HFrEF mortality and morbidity, and provides practical guidance on patient referral, device selection, implant timing and patient-centred follow-up.
Keywords
Humans, Heart Failure, Stroke Volume, Consensus, Defibrillators, Implantable, Cardiac Resynchronization Therapy, Europe, Patient‐centred heart failure care, Sudden cardiac death, Cardiac dyssynchrony, Cardiac implantable electronic device, Implantable cardioverter‐defibrillator, Cardiac resynchronization therapy
Published Open-Access
yes
Recommended Citation
Bozkurt, Biykem; Mullens, Wilfried; Leclercq, Christophe; et al., "Cardiac Rhythm Devices in Heart Failure With Reduced Ejection Fraction – Role, Timing, and Optimal Use in Contemporary Practice. European Journal of Heart Failure Expert Consensus Document" (2025). Faculty and Staff Publications. 4066.
https://digitalcommons.library.tmc.edu/baylor_docs/4066