Interventional heart failure: A new field

With the rapid expansion of interventional therapies for structural heart disease, it is no surprise that the field of interventional heart failure (HF) is now an established reality. Why is there a need for interventional treatment of HF? Despite critical advances in the treatment of some forms of HF, there are still major unmet needs in the HF field (e.g., HF with preserved ejection fraction and right ventricular failure), and HF-related morbidity and mortality remain high. Furthermore, there are several advantages to device-based therapies for HF: They may help reduce polypharmacy and the need for patient compliance with pharmacotherapies, both of which continue to plague the treatment of HF. For these reasons and others, there has been a plethora of development within the interventional HF field, with therapies ranging from interatrial shunt devices to left ventricular partition devices. Here we discuss the current unmet need for interventional HF therapies, lessons learned from prior successes and challenges in the development of device-based HF therapeutics, novel interventional therapies on the horizon for HF patients, and future challenges that will be critical for all those in the field to consider when developing interventional therapies for HF.