Novel drug mechanisms in development for heart failure.

Heart failure therapy has seen many advances over the last 40 years and has rapidly expanded beyond diuretics and digoxin to include several new mechanisms of action and devices whose efficacy had been demonstrated in large clinical trials. The evidence for their use is thoroughly summarized and discussed in current heart failure treatment guidelines and is not the subject of this review. Despite these advances, the mortality and morbidity in heart failure patients is still substantial, and there remains a need to develop new heart failure therapies.

Percutaneous methods of left atrial appendage exclusion: an alternative to the internist.

Thromboembolic stroke from the left atrial appendage (LAA) is the most feared complication in patients with atrial fibrillation (AF). The cornerstone for the management of chronic non-valvular AF is stroke reduction with oral anticoagulation (OAC). However, poor compliance, maintaining a narrow therapeutic window, and major side effects such as bleeding have severely limited their use, which creates a therapeutic dilemma.