Mechanical circulatory support has emerged as an important therapy for advanced heart failure. These devices significantly improve survival and quality of life and should be considered in every patient with end-stage heart failure with reduced ejection fraction who has no other life-limiting diseases.

Devices, such as implantable cardioverter-defibrillators (ICDs), and novel pacing technologies, including cardiac resynchronisation therapy (CRT), have helped to complement goal-directed medical therapy and positively impact prognosis in these patients, as demonstrated in multiple high-quality clinical trials.