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Complex Care Options for Patients With Advanced Heart Failure Approaching End of Life

  • Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise (A Hasan, Section Editor)
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Abstract

Care for patients with advanced cardiac disease continues to evolve in a complex milieu of therapeutic options, advanced technological interventions, and efforts at improving patient-centered care and shared decision-making. Despite improvements in quality of life and survival with these interventions, optimal supportive care across the advanced illness trajectory remains diverse and heterogeneous. Herein, we outline challenges in prognostication, communication, and caregiving in advanced heart failure and review the unique needs of patients who experience frequent hospitalizations, require chronic home inotropic support, and who have implantable cardioverter-defibrillators and mechanical circulatory support in situ, to name a few.

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Abbreviations

EOL:

End of life

QOL:

Quality of life

ICD:

Implantable cardioverter-defibrillator

LVAD:

Left ventricular assist device

HF:

Heart failure

DT:

Destination therapy

MCS:

Mechanical circulatory support

CMS:

Centers for Medicare & Medicaid Services

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Correspondence to Sara E. Wordingham.

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Conflict of Interest

Sara E. Wordingham and Colleen K. McIlvennan declare that they have no conflict of interest.

J. Nicholas Dionne-Odom is a postdoctoral fellow supported by a National Palliative Care Research Center Career Development Award.

Keith M. Swetz has received salary support from the US Federal Government (Department of Veterans Affairs; Birmingham Veterans Affairs Medical Center).

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise

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Wordingham, S.E., McIlvennan, C.K., Dionne-Odom, J.N. et al. Complex Care Options for Patients With Advanced Heart Failure Approaching End of Life. Curr Heart Fail Rep 13, 20–29 (2016). https://doi.org/10.1007/s11897-016-0282-z

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