Heart Failure with Preserved Ejection Fraction: Can Device Therapy Be Our Option?

Heart failure with preserved ejection fraction (HFpEF) comprises half of the total heart failure (HF) population. It is a unique class of patients whose systolic heart function is preserved but have impaired diastolic function leading to symptoms typical of HF. In the era of 1980s and 1990s, ‘congestive heart failure’ was used to refer to all the HF patients. With a better understanding of pathophysiology of ‘diastolic HF’, the term ‘HFpEF’ got widespread acceptance in early 2000s. Despite the increasing awareness of pathophysiology and diagnostic modalities for this group of HF patients, it is unfortunate to say that the therapies that we can provide are limited when compared to their counterpart HF with reduced ejection fraction (HFrEF) group. This review will focus on the use of device therapy in patients with HFpEF, particularly implantable cardioverter defibrillator and cardiac resynchronization therapy.