Biventricular pacing

Several new medical advances benefit people with heart failure. One is the biventricular pacemaker, which synchronizes the rhythm of the heart's chambers (cardiac resynchronization). It has been shown to improve quality of life in people who have severe heart failure and problems with the heart's electrical system.⁷ New guidelines from the American Heart Association recommend biventricular pacing for people with severe heart failure.¹³ Further studies are ongoing to see whether this therapy might also benefit those with less severe heart failure.

Implantable defibrillators (ICDs)

A device that combines an implantable cardioverter-defibrillator (ICD) with a biventricular pacemaker is now available for some people with heart failure. The ICD part of the device continuously monitors the heart for life-threatening, rapid heart rhythms. When these dangerous heart rhythms occur, the device delivers an electric shock to the heart to restore a normal rhythm. The biventricular pacing part sends weak electrical shocks that make the left and right lower chambers (ventricles) contract at the same time. This double contraction helps the heart to pump blood better. Studies show better quality of life, improved capacity for exercise, and longer life in people with this combination pacemaker/ICD device compared with those who had only a biventricular pacemaker.¹⁴

Other Treatment Choices

Pacemakers, including biventricular pacemakers (resynchronization therapy)

Enhanced external counterpulsation (EECP), a treatment sometimes used for heart failure

Cardiac rehabilitation is often recommended in the treatment of heart failure before or after pacemaker implantation or other surgical interventions. For more information, see the topic Cardiac Rehabilitation.

Doctors also may use an intra-aortic balloon pump to stabilize a person during sudden heart failure.

What to Think About

Complementary or alternative therapy

No convincing evidence shows that nutritional or certain vitamin supplements are effective for treating heart failure.² Some European studies from the early 1990s suggest that the supplement coenzyme Q10 improves heart failure symptoms; more recent studies have shown no effect.¹⁵ In any case, coenzyme Q10 should not be a substitute for the standard treatment for heart failure.

Hawthorn is an herbal supplement that contains flavonoids. It dilates blood vessels to increase blood flow to the heart. German studies have shown improvement of mild heart failure in some people who took hawthorn. It is sometimes recommended in Europe and Asia for treatment of heart failure.¹⁶

Talk to your doctor about whether supplements are safe for you.