Treatment Options

Heart failure is an increasingly complex and common condition. According to recent statistics from the National Heart, Lung and Blood Institute, one in five people will develop heart failure in their lifetime. Heart failure is challenging to manage because many people with the condition also have coronary heart disease, diabetes or high blood pressure.

We can provide patients with a number of medical and surgical approaches to manage heart failure.

Medications

Medications for treatment of heart failure include:

• ACE-inhibitors/Angiotensin receptor blockers (ARB)
• Beta-blockers
• Diuretics
• Aldosterone antagonists
• Digoxin
• Hydralazine
• Nitrates
  

Other options include intravenous inotropic and vasodilator therapy (drugs that make your heart beat more strongly and widen your blood vessels to allow better blood flow to your heart).

Taking Medications

Medications for heart failure help to reduce the work of your heart and may help your heart beat stronger. Taking your medications regularly can help you feel better and stay out of the hospital.

It's important to get your prescriptions filled regularly without missing any doses. Read the labels carefully and have all your medications filled at the same pharmacy. This will help the pharmacy keep accurate records of all your medicines and avoid any unsafe interactions between medications.

Always take your medicine as directed. Even if you feel better, do not stop taking medicine without first talking to your doctor or nurse.

Lifestyle Changes

Diet, exercise and other healthy habits can help control symptoms of heart failure and improve your overall health and well-being. The following lifestyle changes can help:

• Avoid alcohol
• Quit smoking
• Lose weight if necessary
• Eat a healthy diet that is low in fat and salt, and high in fiber
• Work with your doctor to develop an exercise program
• Manage your stress

Some patients will also need fluid restrictions that limit them to 2 liters per day.

Device Implants and Pacemakers

UVA also uses implantable devices, including:

Implantable cardiac defibrillators: These battery-powered small devices generate electrical impulses that perform biventricular pacing in patients with heart failure.

Cardiac resynchronization therapy: This treatment uses a special pacemaker that synchs the left and right ventricles of heart failure patients. This can be combined with an implantable cardiac defibrillator.

Mechanical-assist devices: An intra-aortic balloon pump (IABP) increases cardiac output and blood flow and ventricular assist devices (VADs), mechanical pumps that help the heart pump blood through the body.

Left ventricular assist device (LVAD): This is a therapy for end-stage heart failure. It’s a battery-operated, mechanical pumping device that is surgically implanted and helps the heart pump blood through the body. We were the first hospital in the state to implant patients with LVADs. 

The newer generation LVAD used at UVA is the smallest pump used in the United States. These LVADs are for patients with end-stage heart failure and can last for three to five years. Patients can go home with these devices rather than stay in hospital.

LVADs also allow critically ill patients to undergo other procedures that they might otherwise be too sick to tolerate. UVA is also certified to use LVADs as an alternative to heart transplant.

Surgery and Transplant

We also treat heart failure with surgical alternatives to transplant, including left-ventricular remodeling, which can increase the pumping efficiency of the heart tissue and valve surgery to replace poorly functioning valves.

We also perform heart transplants for the most severe heart failure cases.