Acute Decompensated Heart Failure

Patient Identification

Identifying the appropriate patients for Impella® consists of analyzing their hemodynamics and lab values, along with performing a patient assessment. Looking for signs of hypoperfusion and/ or hypotension.1,2,3,4

Patients May Be Sliding Into Cardiogenic Shock if They Have:

Patients may be sliding into cardiogenic shock image Patients may be sliding into cardiogenic shock image

 

Take Into Account the Patient’s Clinical Classification

Depending on the staging or profiling tool employed, Impella is recommended for patients in cardiogenic shock or refractory shock, SCAI stage C, Intermacs Profile 2-3, NYHA Advanced Class IV and ACC/AHA Stage D.2

Differentiating heart failure types is crucial for a tailored treatment. De novo heart failure presents a higher incidence of in-hospital death, cardiac arrest and SCAI stage escalation compared to acute on chronic heart failure. However, de novo HF has a greater likelihood of myocardial recovery than its acute on chronic counterpart.5-7

 

Why Impella for Heart Failure Patients?

Impella provides the heart team more time to assess and plan a long-term treatment strategy. Impella provides hemodynamic support and forward flow, unloading the left ventricle which perfuses end organs.8-12 It also allows the heart to rest, promoting myocardial recovery.8-12

The Procedure

Learn more about identifying the appropriate patients and review patient clinical classification.

References

  1. Radakovic, D., et al. (2023). Life (Basel), 13(2), 582.
  2. Abraham, J., et al. (2021). Journal of Cardiac Failure, 27(10), 1126-1140.
  3. Belkin, M. N., et al. (2021). Journal of Cardiac Failure, 27(10), 1045-1052.
  4. Kang, G., et al. (2016). The Journal of Heart and Lung Transplantation, 35(1), 67-73.
  5. Hernandez-Montfort, J. et al. (2023). JACC Heart Fail, 11(2), 176-187.
  6. Sinha, S. S. et al. (2022). Circulation: Heart Failure, 15(6), e009279.
  7. Greene, S. J. et al. (2021). JACC, 77(7), 1023-1025.
  8. Wilcox, J. E. et al. (2020). JACC, 76(6), 719-734.
  9. Kanwar, M. K. et al. (2022). The Journal of Heart and Lung Transplantation, 41(10), 1324-1334.
  10. Wever-Pinzon, J. et al. (2016). JACC, 68(16), 1741-1752.
  11. Gerhard, E. F. et al. (2021). The Journal of Heart and Lung Transplantation, 40(12), 1560-1570.
  12. Wever-Pinzon, O. et al. (2022). The Journal of Heart and Lung Transplantation, 41(10), 1309-1323

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