The role of device therapy in heart failure with reduced ejection fraction(HFrEF) : a narrative review

Heart failure has gained increasing notice due to its high prevalence and mortality rate. The management for heart failure has been emphasized on the role of device therapy. Implantable cardioverter defibrillator(ICD) and cardiac resynchronization therapy(CRT) were given strong recommendation for heart failure with reduced ejection fraction(HFrEF), considering their effectiveness on preventing sudden cardiac death(SCD), improving cardiac function and benefiting survival. In this review, we explained the underlying mechanisms of disease initiation and progression in HFrEF, in order to build the connection between the pathological basis of HFrEF and the rationality of ICD and CRT on terminating ventricular arrhythmia, improving cardiac function, decreasing the rate of adverse clinical outcomes and benefiting survival. In addition, we discussed the high-quality researches with significant values on the discovery of device therapy clinical benefits, and compared the class I recommendations for device therapy in HFr EF, suggested by American Heart Association and European Society of Cardiology.