The most up-to-date definition of advanced heart failure includes symptoms refractory to conventional treatment, independent of ventricular ejection fraction
left, accompanied by elevation of natriuretic peptides. In this new definition,
highlight specific conditions such as the usual need for an intravenous diuretic, frequent hospitalizations or visits for heart failure, intermittent inotropic medication and
recurrent malignant arrhythmias.
This condition is present in approximately 4 a 6% of patients with heart failure and
is associated with more symptoms, more comorbidities and higher mortality (until 75% to an anus). in this
point, conventional therapies have failed or are refractory and decision-making is required to institute more advanced treatments (p. not.: inotropics, ventricular assist,
heart transplant, palliative care, inter).
Treatment represents a challenge for Colombian health systems due to the need
to optimize and rationalize the use of these resources; for this reason it should be considered that these
patients, at some point in its evolution, that are referred for evaluation in the Heart Failure Clinics since these services have highly qualified personnel and a
administrative structure, logistics and technology that guarantee access to treatment
comprehensive and multidisciplinary with international quality standards which is what finally
is required under these conditions.
Different options are presented in the ‘‘ Colombian Consensus on Advanced Heart Failure ’’
treatment to consider and a comprehensive care model that begins from the moment of
diagnosis up to refractory and advanced stages