Non-Pharmacological Treatment of Heart Failure-From Physical Activity to Electrical Therapies: A Literature Review.
Antonio ScaràZefferino PalamàAntonio Gianluca RoblesLorenzo Lupo DeiAlessio BorrelliFederico ZaninLeonardo PignalosaSilvio RomanoLuigi SciarraPublished in: Journal of cardiovascular development and disease (2024)
Heart failure (HF) represents a significant global health challenge that is still responsible for increasing morbidity and mortality despite advancements in pharmacological treatments. This review investigates the effectiveness of non-pharmacological interventions in the management of HF, examining lifestyle measures, physical activity, and the role of some electrical therapies such as catheter ablation, cardiac resynchronization therapy (CRT), and cardiac contractility modulation (CCM). Structured exercise training is a cornerstone in this field, demonstrating terrific improvements in functional status, quality of life, and mortality risk reduction, particularly in patients with HF with reduced ejection fraction (HFrEF). Catheter ablation for atrial fibrillation, premature ventricular beats, and ventricular tachycardia aids in improving left ventricular function by reducing arrhythmic burden. CRT remains a key intervention for selected HF patients, helping achieve left ventricular reverse remodeling and improving symptoms. Additionally, the emerging therapy of CCM provides a novel opportunity for patients who do not meet CRT criteria or are non-responders. Integrating non-pharmacological interventions such as digital health alongside specific medications is key for optimizing outcomes in HF management. It is imperative to tailor approaches to individual patients in this diverse patient population to maximize benefits. Further research is warranted to improve treatment strategies and enhance patient outcomes in HF management.
Keyphrases
- cardiac resynchronization therapy
- left ventricular
- heart failure
- catheter ablation
- atrial fibrillation
- left atrial
- physical activity
- acute heart failure
- end stage renal disease
- hypertrophic cardiomyopathy
- ejection fraction
- left atrial appendage
- mitral valve
- acute myocardial infarction
- randomized controlled trial
- aortic stenosis
- metabolic syndrome
- newly diagnosed
- public health
- peritoneal dialysis
- prognostic factors
- healthcare
- oral anticoagulants
- type diabetes
- global health
- body mass index
- direct oral anticoagulants
- transcatheter aortic valve replacement
- patient reported outcomes
- mental health
- stem cells
- social media
- coronary artery disease
- cardiovascular disease
- venous thromboembolism
- depressive symptoms
- insulin resistance
- adipose tissue
- cell therapy
- antiretroviral therapy