Stage A High Risk for developing Heart failure Stage B Asymptomatic LV dysfunction Stage C Past or current Symptoms of HF Stage D End-stage HF Stages of HF: ACC/AHA Class I symptoms at activity levels that would limit normal individuals Class II symptoms of HF with ordinary exertion Class III symptoms of HF with less than ordinary exertion Class IV Symptoms of HF at rest NYHA Functional Class
Permanent mechanical support Implantable Cardioverter- Defibrillators (ICDs)
An ICD is recommended as secondary prevention to prolong survival in patients with current or prior symptoms of HF and reduced LVEF who have a history of cardiac arrest, ventricular fibrillation, or hemodynamically destabilizing ventricular tachycardia. ICD therapy is recommended NYHA functional class II or III symptoms while undergoing chronic optimal medical therapy, and have reasonable expectation of survival with a good functional status for more than 1 year.
Permanent mechanical support Cardiac Resynchronization Therapy(CRT )
Recommended in Patients with LVEF less than or equal to 35%, sinus rhythm, and NYHA functional class III or ambulatory class IV symptoms despite, optimal medical therapy and who have cardiac
dyssynchrony, which is currently defined as a QRS duration greater than 120 ms, should receive cardiac resynchronization therapy
Right Atrial Lead Right Ventricular Lead Left Ventricular Lead