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
- newly diagnosed
- acute myocardial infarction
- left atrial appendage
- mitral valve
- randomized controlled trial
- public health
- healthcare
- global health
- chronic kidney disease
- ejection fraction
- stem cells
- venous thromboembolism
- skeletal muscle
- type diabetes
- peritoneal dialysis
- oral anticoagulants
- direct oral anticoagulants
- patient reported outcomes
- adipose tissue
- social media
- systematic review
- coronary artery disease
- risk assessment
- smoking cessation
- combination therapy