Heart failure doesn’t mean your heart has stopped working. It just isn’t working as well as it should to
Recent treatment advances can help your ticker work better, keep you out of the hospital, and improve your
quality of life.
High-tech implants can help your doctor check how your heart is doing in real time, so you can adjust your
medications to feel better quickly. Research on new blood and genetic testing may soon make it easier for
doctors to diagnose heart failure earlier or spot who’s most at risk for it.
“Heart failure is no longer about ‘failure,’” says Clyde W. Yancy, MD, chief of the division of cardiology at
Northwestern University. “The array of medical and device therapies, and the insight we now have regarding
prevention, makes this both a preventable and treatable condition.
“The outlook for those with heart failure has never been better.”
Heart failure medicines can help you live longer, feel better, or treat your symptoms. To lower your blood
pressure or slow your heart rate, you may take:
- ACE inhibitors
- Something your doctor will call “aldosterone antagonists,” which help you get rid of salt and water
- Diuretics, sometimes called “water pills”
Two new heart drugs can also help lower your chances of hospital visits because of your heart failure.
Ivabradine (Corlanor): This slows your heart rate, which may cut your time in the hospital, says Brian
Lowes, MD, PhD, chair of cardiology at the University of Nebraska Medical Centre.
It may be right for you if:
- Your heart failure is caused by problems in your heart’s lower left chamber
- You have a normal heartbeat
- You take beta-blockers
Sacubitril/Valsartan (Entresto): Lowes says this combination of two heart drugs can lessen your time in
You’ll probably also keep taking other heart meds with this new treatment, but it can’t be used with
Using meds to manage heart failure isn’t the best choice for everyone. Devices like the ones described below
can help your heart beat normally and may be a good option for you.
Left ventricular assist device (LVAD): Your left ventricle is the big chamber on the left side of your heart.
Its muscles pump blood to your body. An LVAD is a pump that’s implanted into that left ventricle and tubes
that pull blood in and out of the heart. It can help your ticker pump blood when it’s too weak to do it on its own.
It’s hooked to a battery you carry outside of your body. If you’re set to get a heart transplant, an LVAD can
keep your heart working until your procedure.
Heart pumps are getting smaller, easier to implant, longer lasting, and better matched with your blood, Lowes says.
Newer LVADs also pump blood continuously, which makes them more efficient than older options.
Implantable cardioverter defibrillator: This gives your heart an electric shock when it senses a life-threatening
change in rhythm. Newer models are implanted under your skin, and they don’t require leads or wires through
Cardiac resynchronization therapy: A type of pacemaker, this tiny, implanted device helps your heart beat in
a regular rhythm. A new type can send electric pulses to more spots on your ticker’s surface. This will mean
you won’t need to have it adjusted as much.
Pacemakers are also being improved. One being tested now that's not yet available is smaller than current ones.
It’s also wireless, and it can be put in through a leg vein instead of by an incision in your chest.
CardioMEMS: A new implant allows doctors to monitor your heart and adjust your treatment, if need be,
It measures the pressure on your arteries and your heart rate. It’s about the size of a small paper clip, and it’s
inserted into an artery without the need for batteries or wires.
Lowes says this allows you to monitor yourself at home. This can help keep you out of the hospital and improve
your quality of life.
Many folks with heart failure need to start over with a new heart through a transplant. But a new option is the
total artificial heart. Made by SynCardia, it's implanted into your heart to replace the lower two chambers that can no longer
pump blood. It has an outside power source.
Another advance is reconstruction surgery, which can reshape your heart so it pumps blood easier.
Your doctor may be able to repair the valves. This can make your heart smaller so it works better.
New tests can help doctors spot heart failure earlier or track your progress, Lowes says. Genetic testing may
predict who’s at risk for the condition or other problems, like atrial fibrillation, that could raise your odds
of heart failure.
Newer blood tests can help your doctor make an early diagnosis and see if your drugs are causing problems.
One such test is to check your level of troponin. The more of this you have, the more damage has been done
to your heart.
No matter which treatments you use, you can do a lot to live longer and have a better quality of life, says
Mary Norine Walsh, MD, medical director of the heart failure and cardiac transplantation programs at St.
Vincent Heart Centre of Indiana.
“The first step is taking medications as directed, on time and every day,” she says. “Most patients can monitor
their weight every day to help check if their fluid status is changing. All patients can benefit from a diet that’s
low in sodium, too.
“All of these steps can have a big impact on your quality of life with heart failure.”