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Treating Advanced Heart Failure Patients

The Unmet Need: Providing Options to Patients Refractory to Optimal Medical Management

Therapy for advanced heart failure patients involves a continuum of options. As optimal medical management (OMM) continues to evolve, medication regimens rely on beta blockers, ACE inhibitors, and angiotensin-receptor blockers to improve function of the failing heart. Implantable cardioverter defibrillators and cardiac resynchronization therapy have become common and appropriate interventions for selected patients whose symptoms continue to progress on optimal medical management.

However, even with these advances, estimates show that over one million patients progress to NYHA Class III or Class IV, experiencing a dramatic reduction in quality of life.1 Cardiac transplantation is limited by the availability of donor hearts. Thousands of eligible patients face an extended waiting period associated with diminished functional capacity and high mortality rates; other patients are not candidates for transplantation.

Patients who become refractory to OMM may be able to experience improved quality of life with the new era of mechanical circulatory support (MCS). With the advent of improved MCS technologies, more patients can now significantly improve their NYHA classification, projected survival and quality of life.

Improvements in Heart Failure Symptoms23,*

The majority of patients who received MCS with a HeartMate II Left Ventricular Assist Device demonstrated vast improvement, progressing from severe heart failure symptoms, even at rest, to being able to resume normal activities with little or no limitation.**

Heart Failure Symptoms

* Based on improvement in New York Heart Association Heart Failure classification 6 months after implantation.

** Results may vary depend on the MCS device used.

HeartMate ll Actuarial Survival23,24

Survival based on Kaplan-Meier analysis was 78% at 6 months and 70% at 12 months.

Heartmate ll Actuarial Survival

Improvements in Heart Failure Walk Test23***

Average distance covered in a 6-minute walk improved 149 meters after 1 month of support and 297 meters after 6 months.

Improvements in Heart Failure Walk Test

***Based on mean distance walked in 6 minutes

Next: Mechanical Circulatory Support (MCS) Therapy

Leslie Miller, MD

"When advanced heart failure patients lose response to OMM, there frequently are no other options and that's where the field of MCS is designed to be the alternative."

Leslie Miller, MD
Heart Failure Cardiologist

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