Cardiovascular News

New Treatment Guidelines
for Heart Failure Patients

If you have heart failure, your doctor may suggest a different treatment at your next visit. The American College of Cardiology (ACC) and the American Heart Association (AHA) recently updated their heart failure guidelines.1 The guidelines tell doctors about new recommendations for treating some heart failure patients.

The ACC/AHA Guidelines

The ACC and AHA — two well-respected groups — worked together to create the guidelines. The groups reviewed the results of medical studies on heart failure. They then recommended certain treatments for various types of heart failure patients. These new guidelines replace the 2001 ACC/AHA recommendations.

Doctors use the guidelines to make treatment decisions. The new treatment recommendations may help patients by:

Reducing heart failure symptoms
Improving quality of life
Possibly allowing people to live longer

What May Change for People with Heart Failure

Below are some highlights of the new recommendations for treating patients with heart failure.

Medications

The new guidelines now suggest beta blockers and ACE (angiotensin converting enzyme) inhibitors for everyone at high risk for heart failure — even if you haven't yet developed symptoms. The previous guidelines suggested only ACE inhibitors. If you cannot take beta blockers or ACE inhibitors, your doctor will probably suggest other medications.

Implantable Devices

Implantable cardioverter defibrillators (also sometimes called defibrillators or ICDs) are now recommended for many more people who have heart failure symptoms and have a low ejection fraction. The guidelines recommend implantable devices because this group is at high risk for sudden cardiac death. An ICD is a device that monitors your heartbeat. If a dangerous arrhythmia (abnormal heart rhythm) occurs, the defibrillator delivers electrical energy to your heart to stop the arrhythmia. In this way, the device can prevent sudden cardiac death.

Cardiac resynchronization therapy (CRT) devices are also recommended for many patients. If you have heart failure symptoms and a low ejection fraction, your doctor may recommend an implantable CRT device. When used along with medications, CRT can help relieve heart failure symptoms that occur when the two sides of your heart don't beat at the same time.

Left ventricular assist devices (LVADs) may be implanted in people on the heart transplant waiting list. If your heart cannot pump well enough anymore, the LVAD helps pump blood to your body. The new guidelines recommend that doctors use the LVAD even in very ill patients who are not candidates for heart transplant.

Talk to your
doctor about
important safety
information.

Other Possible Changes

Your doctor might also talk to you about other changes in the guidelines. For example, the new guidelines suggest:

Using the term "heart failure" rather than "congestive heart failure" because it's more accurate.
Limiting the amount of sodium (salt) in your food if you have any heart failure symptoms.

The guidelines also recommend that doctors talk with very ill patients about end-of-life issues. Heart failure can be treated, often for many years. But some people can also eventually die from heart failure. Therefore, the guidelines urge doctors to recommend care — such as hospice — that can make very ill patients more comfortable.

Doctors work hard to find the best treatments for their heart failure patients. The new ACC/AHA guidelines offer doctors even more choices to help heart failure patients — and people at risk for heart failure.

American Heart Association. American Heart Association Statement August 16, 2005. Available at: http://www.americanheart.org/presenter.jhtml?identifier=3032954. Accessed March 17, 2006.