Advanced Heart Failure Therapy Center
Advanced Heart Failure Treatments and ServicesThe sooner heart failure is diagnosed and treated, the better the outcome. When possible, treatment eases heart failure symptoms, and targets the underlying cause. For example, if a too-fast heart beat caused your heart failure, we’ll treat the fast rhythm. If high blood pressure caused your heart failure, we’ll work to control it (less than 130/85 mmHg).
Your heart failure treatment plan may include a combination of medicines, therapies and sometimes surgery.
Heart Failure Medicines
It’s common for people with heart failure to take five or more medicines daily. Each one works in a different way to improve your condition. Some improve heart function to help you live longer. Others relieve symptoms to give you a better quality of life. Keep a current list of your medications with you at all times (in your wallet or purse).
Beta Blockers – These drugs slow the heart rate, reduce heart rhythm problems, lower blood pressure and strengthen your heart.
Angiotensin Converting Enzyme (ACE) Inhibitors – ACE inhibitors widen blood vessels so your heart doesn’t have to work as hard to pump blood through them. These medications help people with heart failure live longer, healthier lives.Angiotensin Receptor Blockers – These drugs work like ACE inhibitors. They relax the blood vessels and can replace ACE inhibitors that cause coughing.
Aldosterone Blockers – These block the effects of a stress hormone called aldosterone.
Vasodilators – Vasodilators relax blood vessels and decrease the heart's workload. Vasodilators are an option if you can’t take an ACE inhibitor.
Digoxin – Digoxin may improve symptoms by helping the heart beat stronger and controlling its rhythm.
Diuretics – Diuretics, or “water pills,” help the kidneys remove extra water and salt from your body (through urine). Diuretics can decrease fluid in your lungs to help ease breathing. They also pull fluid away from your belly, legs, hands and feet.
Potassium – Potassium is an important electrolyte in your body. You can lose it through urine, so you may need a potassium supplement if you take a diuretic. Potassium is available as a generic or brand-name drug, most of which start or end with K (the elemental symbol for potassium).
Inotropes – Inotropes are intravenous (IV) drugs given through a vein. In advanced heart failure, they stimulate your weakened heart to pump more effectively. These drugs increase the force of your heart's contractions and relax your blood vessels. The goal is to improve the amount of blood ejected from your heart and circulated to the rest of your body.
Medicines and Supplement Precautions
Check with your cardiologist before taking any over-the-counter medicines, vitamins or herbal supplements. People who have heart failure may process medicines differently due to altered blood circulation. Toxic drug interactions between cardiac medicines and some herbs or supplements may occur.
Device Implants and Cardiac Surgery
Sometimes patients develop advanced heart failure despite medical therapy. If that happens, you may have options for advanced treatments like device implants or cardiac surgery.
Emory offers device clinics throughout Georgia to provide our patients with convenient and comprehensive follow-up care.
Cardiac Resynchronization Therapy (and other pacemakers)
Cardiac resynchronization therapy (CRT) is a pacemaker treatment. If you have an enlarged heart (cardiomyopathy) that often beats in an uncoordinated (dys-synchronized) way, CRT may be right for you.
Pacemakers are small metal devices implanted under your skin. Insulated wire(s) connect the pacemaker to your heart chamber. These wires, called leads, send electrical impulses that stimulate your heart to beat, or correct an abnormal heart rhythm. CRT helps your left and right ventricles to contract in a coordinated (synchronized) manner.
“Resynchronization” puts your heartbeat back in synch. This therapy is also called bi-ventricular pacing.
Implantable cardiac defibrillators (ICD) can help if you’re at high risk of developing a dangerous and life-threatening abnormal heart rhythm.
A defibrillator is a small device implanted under your skin, like a pacemaker. It treats abnormal and possibly deadly heart rhythms. The device fits into the palm of an average-sized female hand. Insulated wires (leads) connect to the ICD to your heart chamber.
An ICD monitors heart rhythms. It works as a pacemaker for slow heart rhythms. It also delivers life-saving shocks for fast heart rhythms.
Coronary Bypass Surgery
Coronary bypass surgery can increase blood flow to an area of your heart. If you have a blockage that reduces blood flow to your heart, your surgeon will take blood vessels from your legs or chest to bypass the blockage and restore adequate blood flow. Your cardiologist can tell you if procedure may be right for you.
Modified DOR Procedure
If you’ve had a heart attack in your left ventricle (lower left chamber of your heart), a thin scar (aneurysm) can form and bulge with each heart beat. In a modified DOR procedure, your doctor removes the aneurysm and restores your left ventricle to its original shape.
Heart Valve Repair or Replacement
If you have mitral or aortic valve regurgitation, your heart valves don’t close completely. This lets blood leak backwards. If you have mitral or aortic valve stenosis, your heart valves don’t open properly. This stops blood from moving forward.
Each condition can cause your heart muscle to pump harder, which can result in heart failure. These valves can be surgically repaired or replaced to improve heart function.
If you have a damaged heart valve, your cardiologist will talk with you about your options.
Heart transplantation or “transplant” removes a damaged heart and replaces it with a healthy heart from a human donor. It’s an excellent option if you’ve exhausted all medical and surgical therapies for heart failure.
Donor availability limits the number of transplantations done each year. Short- and long–term results are generally good. Emory surgeons have performed more than 750 adult heart transplant surgeries since 1988, more than any other provider in the state of Georgia.
Ventricular Assist Devices (VAD)
Ventricular assist devices (VADs) are surgically attached to your heart to help with its workload. Most often, devices are attached to your left ventricle (called LVAD for left ventricular assist devices).
If your heart failure symptoms suddenly get worse (called acute decompensated heart failure), VADs can help you survive until you can have a heart transplant.
Newer models may be used as a permanent device or “destination therapy.” This option helps if you have end stage (severe) heart failure without an option for transplantation, or if you prefer to have the VAD implanted as a long-term, life-sustaining measure.
Heart failure is a chronic (ongoing) condition that may be varied and unpredictable. If you are diagnosed with heart failure, stick to the treatment plan designed by your doctors and nurses. Learn which key symptoms may be serious warnings of trouble. Let your doctor and nurses guide you so you can control your heart failure signs and symptoms.
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