Device Therapy for Heart Failure Patients

Sarah J. Goodlin, Mandeep R. Mehra

Research output: Chapter in Book/Report/Conference proceedingChapter


This chapter focuses on the state of knowledge in the evidence-based management of heart failure (HF) using device therapy. In particular, it summarizes the indications for, and the management of, implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) in HF. ICDs are small sophisticated devices implanted under the chest wall with leads into the myocardium through the venous system to detect and terminate arrhythmias with electroshock and/or pacing. The benefits, adverse outcomes, management and discontinuation of ICDs in HF patients are shown. CRT is obtained with a pacemaker-sized device that is implanted with three leads into: the atrium, the right ventricle, and via the coronary sinus into a vein on the lateral free wall of the left ventricle. The management of resynchronization devices is illustrated. In addition, decisionmaking with patients about CRT is covered. Both ICD and CRT should be implanted after careful review with the patient of device actions, potential benefits, and burdens.

Original languageEnglish (US)
Title of host publicationSupportive Care in Heart Failure
PublisherOxford University Press
ISBN (Electronic)9780191730030
ISBN (Print)9780198570288
StatePublished - Nov 17 2011
Externally publishedYes


  • Cardiac resynchronization therapy
  • Heart failure
  • Implantable cardioverter defibrillator
  • Implantation
  • Management

ASJC Scopus subject areas

  • Nursing(all)


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