Devices in heart failure; diagnosis, detection and disease modification.

Introduction/background: Implantable cardiac devices are widely used in chronic heart failure (CHF) therapy. This review covers current CHF treatment with electronic cardiac devices, areas of discussion and emerging technologies. Sources of data: A comprehensive search of available literature resources including Pubmed, MEDLINE and EMBASE was performed. National and international guidelines were accessed. Areas of agreement: Excessive right ventricular pacing is detrimental to cardiac function. Cardiac resynchronization therapy is beneficial in specific individuals with CHF. Areas of controversy: Implantable cardioverter defibrillators might not benefit all. Optimizing CRT delivery. Remote monitoring seems not to be of benefit in CHF. Growing points: Device-based optimization. Areas timely for developing research: Personalization of device therapy. Focussing implantable cardioverter defibrillator therapy. What to do at implantable cardioverter defibrillator box change?