Heart Failure Program

Heart failure, or congestive heart failure, is a complex cardiovascular condition in which the heart’s muscle isn’t working properly and can’t pump enough blood to meet the body’s needs. There are two types of heart failure:

• Systolic heart failure: Also called heart failure with reduced ejection fraction (ejection fraction measures the amount of blood pumped out of the heart), this is when your lower left heart chamber (called the left ventricle) does not contract with enough force.
• Diastolic heart failure: Also called heart failure with preserved ejection fraction, this is when the heart’s lower chambers (ventricles) are stiff and can’t fill with enough blood.

The Heart Failure Program at Cleveland Clinic Abu Dhabi’s Heart, Vascular & Thoracic Institute is at the very forefront of cardiovascular medicine innovation and comprehensive patient care. We offer patients with heart failure access to the most advanced diagnostic and treatment options available in the world, including cutting-edge technological advances and life-saving procedures.

Our multidisciplinary team of experts is led by world renowned cardiologists, cardiovascular and cardiothoracic surgeons. From treatment with lifestyle changes and innovative medical therapies, through to complex surgical procedures and heart transplant, we offer a range of comprehensive services that are tailored to each patient, with a focus on preventing the condition from getting worse, controlling symptoms and helping the patient achieve the best quality of life possible.

What We Treat

The Heart Failure Program specializes in the care of patients with:

• Advanced congenital heart disease
• All types of heart failure
• Amyloidosis related heart failure
• Arrhythmogenic right ventricular dysplasia (ARVD)
• Cardiac sarcoidosis
• Cardiogenic shock
• Dilated cardiomyopathy
• Giant cell myocarditis
• Heart failure due to arrhythmias
• Heart failure due to cancer therapies
• Heart failure due to valve disease
• Heart failure with preserved ejection fraction
• Heart failure with reduced ejection fraction
• Heart transplant
• Hypertrophic cardiomyopathy
• Inherited disorders that cause heart failure
• Ischemic cardiomyopathy
• Other types of myocarditis
• Peripartum cardiomyopathy
• Restrictive cardiomyopathy.

The Heart Failure Program offers every patient personalized diagnostic and treatment options to meet their individual needs. We utilize the most advanced technology to ensure the highest standards of care and best possible outcomes.

Diagnosis of Heart Failure

The first sign of heart failure is usually a decreased tolerance of exercise and activity, and a shortness of breath. Clinical diagnosis begins with a discussion of the patient’s symptoms and medical history and performing a physical examination.

Our team then use several, non-invasive diagnostic tests and advanced imaging technologies, which may also be used during the management of heart failure, including:

• Electrocardiogram: An ECG takes a recording of the heart’s electrical activity to detect abnormalities.
• X-ray:Images of the heart and inside the chest may be taken.
• High-resolution echocardiography and cardiac MRI: These imaging modalities provide detailed images of the heart's structure and function, aiding in the accurate diagnosis of heart failure and in monitoring the effectiveness of treatments.
• 3D Printing: Utilized for pre-surgical planning, 3D printing allows for the creation of patient-specific heart models. This aids surgeons in planning complex heart surgeries or interventions, improving surgical outcomes.

Sometimes, a diagnosis may also require invasive tests, like cardiac catheterization, to observe blood flow and blood pressure.

Treatment of Heart Failure

For some, lifestyle changes and medication can treat heart failure effectively. For others, surgery may be required. For patients with end-stage heart failure, a heart transplant may be required. The treatment prescribed will depend on many factors, including the type of heart failure and its cause.

Learn more about treatments for heart failure here.

Lifestyle changes and medication

Our nurses, dietitians and cardiac rehabilitation team works with patients to help them develop a diet, exercise and lifestyle program that will help them to control heart failure symptoms. Most people with heart failure are treated with medication, so we work with patients to ensure they are on the right type and amount of medication to keep their heart failure from getting worse and to reduce symptoms.

Remote monitoring

We use state-of-the-art, implanted devices which allow remote monitoring of our patients’ conditions. The monitor alerts our team before any symptoms are noticed by the patient. With the information gathered, we can adjust medication and avoid hospitalization.

Electrical device management

For patients with advanced heart failure, small electrical devices can be implanted to monitor or control the heart’s rhythm. Implanted devices include:

• Pacemakers: Monitor the heart’s rate and send an electrical impulse to keep it beating at the correct rate.
• Cardiac resynchronization therapy (CRT): Ensures the walls of the left ventricle are contracting at the same time.
• Implantable cardioverter defibrillators (ICDs): Constantly monitors the heart’s rhythm and deliver a controlled shock when needed.
• CRT-Ds: Cardiac resynchronization and defibrillation (CRT-Ds).
• Pulmonary artery pressure sensors: Send blood pressure readings to a monitor accessed by medical teams, alerting them to when medication needs adjusting.

Surgery

We offer advanced, minimally invasive, and robotically assisted surgical procedures to manage complex cases of heart failure.

• Catheter ablation: A minimally invasive procedure to treat abnormal heartbeats.
• Coronary artery bypass graft surgery: Offered to people with coronary artery disease.
• Coronary angioplasty and stent: A minimally invasive procedure, also used to treat coronary artery disease.
• Heart valve surgery: Procedures either to repair or replace damaged or diseased heart valves.
• Ventricular assist devices (VADs): Implanted devices that help the heart to pump blood properly from the lower chambers.
  • Left ventricular assist devices (LVADs): Placed in the left lower heart chamber, often given to patients waiting for a heart transplant.
  • Biventricular Assist Devices (BiVADs): Given when both heart ventricles are failing.

Learn more about advanced surgical treatment options for heart failure here .

Heart transplant

A heart transplant is a major surgery given to patients with end-stage heart failure. The damaged heart is replaced with a healthy one from a donor.