Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2025.030

Personalised treatment strategies in heart failure: A literature review and new proposed algorithm for device therapy selection

Lucie Kohoutkova1, 2, Martin Augustynek1, Henryk Szymeczek3
1 Department of Biomedical Engineering, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, Ostrava, Czech Republic
2 Department of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava, Czech Republic
3 Department of Cardiology, Trinec Hospital, Trinec, Czech Republic

Heart failure remains a major global health challenge, characterized by high morbidity, mortality, and economic burden despite continuous advances in therapy. This review summarizes landmark clinical trials that have shaped current approaches to device therapy in heart failure, including implantable cardioverter-defibrillators, cardiac resynchronization therapy, and emerging conduction system pacing. In addition, it discusses novel prognostic and monitoring methods such as impedance cardiography and dobutamine stress echocardiography, which enable more precise patient assessment. Based on the available clinical data, we propose a new four-step decision algorithm for personalised device therapy selection in heart failure, integrating etiology-specific risk stratification, electrical and functional evaluation, and prognostic modifiers. The integration of evidence-based interventions and phenotype-driven decision-making supports a proactive and individualized approach to improving outcomes and quality of life in patients with heart failure.

Keywords: heart failure, implantable cardioverter-defibrillator, cardiac resynchronization therapy, conduction system pacing, impedance cardiography, prognosis, personalised medicine

Received: July 31, 2025; Revised: October 25, 2025; Accepted: November 6, 2025; Prepublished online: November 21, 2025 

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