New implantable devices for cardiovascular management and especially for heart failure

The concept of using a cardiac implantable device (CID) to manage arrhythmias and heart failure started over 50 years ago. Since then, we have seen these CID improve patient outcomes from bradyarrhythmias, atrial fibrillation, ventricular arrhythmias, and heart failure (HF). These devices are now standard of care in the management of patients and include pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy or combination devices.This technology of implantable heart rhythm monitoring and therapeutic devices has only been established in the last few decades. Recent advances in such technology have led to simpler implantation techniques, greater patient convenience with smaller device sizes, leadless pacemakers, extended battery longevity, increased device safety and reliability, and improved clinical outcomes. Early detection of worsening HF by implantable sensors allows corrective therapy for acute decompensation. The future may hold expansion of the indications for these CID, with careful examination of the outcomes of today's patients. In addition, there is very exciting new technology that may further advance the management of arrhythmias and HF.