Pumped Up for Heart Failure- 2024 Quality Summit Presentation (Non-CE)-Pumped Up for Heart Failure

Video Transcription

Video Summary

The video discusses the management of ventricular arrhythmias and prevention of sudden cardiac death based on the 2018 Clinical Practice Guideline. Key recommendations include using ICDs (Implantable Cardioverter Defibrillators) for patients with ischemic and non-ischemic cardiomyopathy with an ejection fraction of 35% or less, provided there's an expected survival of over a year. The importance of patients being assessed after optimization on GDMT (Guideline-Directed Medical Therapy) is stressed, highlighting the highest level of evidence for these recommendations. The talk also covers GDMT classes: ARNI, ACE inhibitors, beta-blockers, MRAs, SGLT-2 inhibitors, and hydralazine nitrates, emphasizing their mortality benefits in heart failure with reduced ejection fraction (HFrEF). It discusses barriers to GDMT implementation, such as healthcare system limitations, patient adherence, and costs—exceeding $2,000 annually for standard medication regimens. There's an emphasis on the need for rapid up-titration of these medications, overcoming therapeutic inertia, and the beneficial impact of GDMT on ejection fraction improvement. Lastly, it addresses considerations for ICD replacements, noting that a significant portion of patients may no longer meet criteria for an ICD after GDMT, potentially reducing the need for replacement.

Keywords

ventricular arrhythmias

sudden cardiac death

ICDs

cardiomyopathy

GDMT

HFrEF

ejection fraction

ARNI

ICD replacement