Advanced Heart Failure
When to Refer?
The UR Medicine Advanced Heart Failure Program offers a complete disease management program where patients receive the following services:
- Extensive individualized education
- Comprehensive outpatient care and treatment
- Clinical research study participation
- Cardiac rehabilitation programs
- Interdisciplinary case management
For many patients, a more long-term solution may involve advanced surgical care, including ventricular assist devices (VAD) and heart transplantation.
Wondering when a patient should be referred to our program?
- Patients with persistent heart failure symptoms, despite optimized medical therapy.
- Patients with a new diagnosis of heart failure who are in need of intensive medical management and education.
- Patients with heart failure who have had multiple hospitalizations for decompensated heart failure.
Advanced heart failure signs that indicate your patient may benefit from a VAD/Heart Transplant Evaluation:
- Inability to walk one block without shortness of breath or fatigue
- Intolerance to beta-blockers
- Intolerance of ACEi/ARBs
- Use of Inotropes during a recent hospitalization
- Hyponatremia; Serum sodium < 133
- Progressive deterioration in renal function (BUN > 40, Creat > 1.6 )
- Frequent ICD shocks
- BNP or NT-proBNP > 5x normal (BNP > 1000)
- 1 heart failure related hospitalization within the past 6 months
- High diuretic requirements (≥1.5mg/kg/day) furosemide or equivalent
- LVEF < 30%
- CRT (resychronization therapy) nonresponder
Our Programs' multidisciplinary team is dedicated to work collaboratively with referring providers to improve the patient's quality of life, prevent recurrent admission and, when possible, improve long-term prognosis.