Device therapy for remodeling in congestive heart failure.

Heart failure is a progressive condition which begins after an inciting event that leads to neurohormonal activation and cardiac remodeling. Medical therapy with beta-blockers and angiotensin-converting enzyme inhibitors has been shown to attenuate neurohormonal changes and left ventricular remodeling. Despite optimal medical therapy, patients often progress, and other therapeutic modalities have been sought to interrupt and reverse the process of remodeling. Various devices have been developed and entered into clinical trials with the intent of promoting reverse remodeling by directly altering the mechanical properties or shape of the left ventricle. This article reviews devices currently undergoing clinical trials.