The following are excerpts [two tables and brief text excerpts] from the 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:
8. Non-surgical device treatment of heart failure with reduced ejection fractionThis section provides recommendations on the use of ICDs andCRT. Currently, the evidence is considered insufﬁcient to support speciﬁc guideline recommendations for other therapeutic technolo-gies, including baroreﬂex activation therapy,217 vagal stimulation, 218 diaphragmatic pacing 219,220 and cardiac contractility modulation;221,222 further research is required. Implantable devices to monitor arrhythmias or haemodynamics are discussed elsewhere in these guidelines.
8.1 Implantable cardioverter-deﬁbrillatorA high proportion of deaths among patients with HF, especiallythose with milder symptoms, occur suddenly and unexpectedly.Many of these are due to electrical disturbances, including ven-tricular arrhythmias, bradycardia and asystole, although some are due to coronary, cerebral or aortic vascular events. Treatments that improve or delay the progression of cardiovascular disease will reduce the annual rate of sudden death, but they may have little effect on lifetime risk and will not treat arrhythmic events when they occur. ICDs are effective in preventing bradycardia and correcting potentially lethal ventricular arrhythmias. Some antiarrhythmic drugs might reduce the rate of tachyarrhythmias and sudden death, but they do not reduce overall mortality and may increase it.
For important details on the above see 8.1.1 Secondary prevention of sudden cardiac death [p 916 of the epdf] and 8.1.2 Primary prevention of sudden cardiac death [p 917 of the epdf]
8.2 Cardiac resynchronization therapy
CRT improves cardiac performance in appropriately selected patients and improves symptoms 286 and well-being 286 and reduces morbidity and mortality. 266 Of the improvement in quality-adjustedlife-years (QALYs) with CRT among patients with moderate to severe HF, two-thirds may be attributed to improved quality of life and one-third to increased longevity.287 [See pp 917 + 918 of the epdf]
8.3 Other implantable electrical devices are discussed on p 919 of the epdf.
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. [PubMed Citation] [Full Text HTML] [Full Text PDF]. Eur J Heart Fail. 2016 Aug;18(8):891-975. doi: 10.1002/ejhf.592. Epub 2016 May 20.
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart
failure – Web Addenda [Full Text PDF -you may need t register for a free ESC account to access this resource]