Enhanced external counterpulsation: bringing the concept of the intraaortic balloon pump to the outpatient setting.

Enhanced external counterpulsation can now be used in patients with congestive heart failure. As our population ages, we will see more patients with this challenging diagnosis. The authors discuss this exciting treatment.

Evaluation of impedance cardiography as an alternative to pulmonary artery catheterization in critically ill patients.

Invasive pulmonary artery catheterization has historically been the method of choice for the evaluation of hemodynamic status. Impedance cardiography (ICG) is an accurate, noninvasive technique to obtain hemodynamic status information without the risk and cost associated with invasive methods. The purpose of this prospective, observational study was to determine whether the availability of ICG could decrease the need for placement of a pulmonary artery catheter in critically ill patients in coronary care units.

Current and potential applications of left ventricular assist devices.

The syndrome of heart failure is epidemic, causing increased hospital admissions, poor survival rates, and a dismal quality of life. Treatment choices include pharmacologic, psychological, and surgical interventions. Recent data suggest that mechanical heart pumps, or assist devices, are viable additions or alternatives to transplantation in management of advanced heart failure.