Tag Archives: heart failure

First UK operation for HF with nerve-stimulating implant The UK’s first operation to tackle heart failure (HF) with a novel nerve-stimulating device was performed recently at Glenfield Hospital, Leicester. The operation was part of the INOVATE-HF clinical trial, a global investigation to determine the safety and efficacy of the an implantable electrical stimulation device (CardioFit,® BioControl Medical), designed to improve heart function in patients with HF. The study will evaluate the system’s ability to reduce hospitalisation and death among patients with HF, while also exploring whether combined treatment with the system and pres

Heart failure The recommendations on devices, drugs and diagnosis in heart failure were developed by the ESC in collaboration with a heart failure association of the ESC. There have been several major updates since the previous guidance published in 2008.  The new updates include: In devices, left ventricular assist devices (LVADs) have been hailed as a step change in the management of heart failure. LVADs are more reliable and lead to fewer complications than in 2008. Until now, LVADs have been used as a temporary measure in patients awaiting a heart transplant. Professor John McMurray (Glasgow, UK), chairperson of the ESC Clinical Practice

Optimised beta blocker therapy in heart failure: is there space for additional heart rate control? Dear Sirs, We undertook a similar audit to Russell et al.1 within the heart failure service of a district general hospital auditing the case notes of 96 patients attending over three months. Applying the SHIFT inclusion and exclusion criteria, we identified only seven patients (6.7%) eligible for ivabradine. Using the SHIFT dataset the number needed to treat to prevent a single hospitalisation due to heart failure was 22.2 Extrapolating our data, over 12 months, we would expect to identify approximately 28 suitable patients. Treating 28 patients

It is predicted that the prevalence of heart failure will continue to rise as more people survive cardiac conditions that not too long ago were deemed fatal, and as clinicians get better at recognising and diagnosing it. This compendium, which has been compiled by experts in the field, serves as an essential reference for anyone who is serious about the topic of heart failure. It provides the information required in a piecemeal fashion without compromising on crucial detail and evidence base, sometimes lacking in other textbooks attempting to condense this broad subject matter. It is presented in an easy to read and uncluttered fashion and th

There is incontrovertible, large-scale, randomised-controlled evidence for morbidity and mortality benefit of beta-blockers in heart failure (trials include MERIT-HF, COPERNICUS, CIBIS II),1-3 she said, but the evidence for adverse effects in lung disease is based on animal studies, case reports and small scale human studies.4 Beta blockade in COPD, however, is fully endorsed by The European Society of Cardiology (ESC), National Institute for Clinical Excellence (NICE) and Cochrane reviews.5-7 Dr Hardman’s presentation highlighted for trainees an important area where significant improvements can be achieved. Cardiac and respiratory func

Historically, CR programmes have been under funded and under resourced; this has resulted predominantly from the absence of a CR specific tariff resulting in the inclusion of the service into the broader cardiology tariff or service level agreements between commissioners and providers. This could be about to change with the proposed introduction of payment by results recognising CR programmes as cost-effective interventions that produce substantial health benefits.2 Resources Resources, at the most basic level, are defined as appropriately qualified staff to deliver exercise programmes within suitable venues. Current recommendations for exerc

The licence follows the results of the SHIfT trial, involving more than 6,000 people, which demonstrated that patients with chronic systolic heart failure and a heart rate over 70 bpm had an 18% reduction (ARR = 4.2% p<0.0001) in the composite primary end point of cardiovascular death and hospitalisation due to heart failure. Ivabradine selectively lowers heart rate and the study showed benefits were greater in patients with higher heart rates (>75 bpm). Within the indication, Servier says ivabradine reduced the risk of death from heart failure by 39% (ARR 2.2% p=0.0006), the risk of death from all types of cardiovascular disease by 17%

Introduction Landmark qualitative studies published within the last decade highlighted inequalities in end-of-life care between people with advanced heart failure (HF) and cancer.1-8 A palliative approach and access to specialist palliative care (SPC) services for people with advanced HF is now underlined in national and international policy.9-14 However, those with HF are still more likely to die in hospital in the UK than cancer patients,15 and UK 2010 national audit figures document less than 4% of people with HF referred for palliative care.16 Hospice referral seems higher in the USA and Canada.17,18 We have previously reported retrospect

Introduction Beta-adrenoceptor blocking drugs (beta blockers) are an established prognostic therapy for chronic heart failure (HF).1-4 Of the many proposed mechanisms mediating these favourable effects, that of heart rate (HR) control is gaining interest. The Systolic Heart Failure Treatment with Iƒ Inhibitor Ivabradine Trial (SHIFT) reported that ivabradine significantly reduced a combined end point of cardiovascular death or HF hospitalisations in a relatively high-risk HF population with an elevated resting HR.5 HR control, therefore, appears to be both a modifiable risk factor and a disease modifying variable in patients with impaired l

Introduction Clinical trials for new heart failure treatments have traditionally focused on mortality and hospitalisations as primary end points.1,2 Although clearly important, these end points tell us little about how heart failure (HF) patients experience their illness and treatment in their day-to-day life. HF may affect patients’ quality of life more than many other chronic diseases, including diabetes and arthritis.3,4 Symptoms and quality of life, as reported by patients, are correlated with mortality and hospitalisations,5-7 suggesting that these concepts may be indicative of an underlying process that ultimately manifests in death a