Other treatments for heart failure

There are other treatments for heart failure depending on the type of heart failure. Your doctor will discuss whether any of these are suitable for you.

Coronary artery stents or bypass surgery

If the cause of your heart failure is a significant narrowing of blood vessels (coronary artery disease), your doctor may recommend an angioplasty and stents. An angioplasty is a procedure to widen arteries. Stents is a procedure where a stainless steel mesh or coil is put into the narrowed artery to keep it open. If this is not possible, bypass surgery may be done to help improve the blood supply to your heart muscle.

During a heart bypass surgery, the surgeon uses a piece of blood vessel from somewhere else in your body to bypass around the narrowings or blockages in the heart blood vessels. This means that the blood supply to your heart is restored to normal.

Valve repair

If the valves in your heart are the cause of your heart problems, your doctor may recommend an operation to fix or replace them.

Device therapies

If you have an abnormal heart rhythm, your medical team may decide to put in a pacemaker to support your heart. A pacemaker is a device that uses painless electrical signals to keep your heart beating regularly and to improve its function. There are different types.

Basic pacemaker

This device consists of one or more leads (thin wires) placed inside the heart muscle and attached to a generator (small box) underneath the skin and muscle usually just under the left collar bone. It works by producing small electrical pulses that cause the heart to beat at a normal rate. A pacemaker may be recommended if you have a slow heart rate bradycardia) or irregular heartbeats.

Implantable Cardiac Defibrillator (ICD)

This may be recommended if you have a more serious disturbance in your heart rhythm. Like the basic pacemaker, it consists of one or more leads placed in the heart muscle and attached to a generator that is placed underneath the skin and muscle below the left collar bone.

The ICD monitors the heartbeat and if it detects an abnormal rhythm, it sends an electrical signal or ‘shock’ to the heart to ‘reset’ the heart rhythm. You would notice a quick ‘thump’ sensation in the chest.

Cardiac resynchronisation therapy (CRT)

This device also consists of a generator (small box) placed underneath the skin and muscle below the left collar bone and attached by one or more leads to the heart muscle. It sends continuous small electrical signals to one or more of the heart chambers to make sure they beat at the same time. A CRT makes the heart pump more efficiently and reduces the pressure inside the heart. It is also possible to get a CRT and ICD combination device called a CRT-D.

Pacemakers are checked often to monitor battery life. Some of them come with a home monitoring system which is usually plugged in at the bedside and the information from the device sent automatically to the clinic.

Left ventricular assist device (LVAD)

This is used for patients with more severe heart failure. The LVAD is a mechanical pump that is placed inside the chest to help the heart pump blood throughout the body. Getting an LVAD involves open heart surgery. In some patients, the LVAD will be left in permanently. Other patients may have a temporary LVAD while they are waiting for a heart transplant.

Heart transplant

If you are not responding to medication or other treatments, your doctor may consider you for a heart transplant. However, transplants are quite rare. There are only about 15 to 20 done each year in Ireland.