Key result
Atrial shunting emerges as a novel therapy for symptomatic heart failure across the entire spectrum.
Why the study?
Reducing the symptomatic burden in patients with advanced HF remains an unmet clinical need despite available pharmacological therapies.
This review summarizes the physiology, devices, and clinical trials of atrial shunting across the spectrum of symptomatic heart failure.
Should not yet change practice in heart failure; leaves open questions of efficacy and safety pending randomized trials.
Despite a plethora of pharmacological therapies for heart failure (HF), reducing the symptomatic burden in patients with advanced HF remains an unmet clinical need. Over the past decade, atrial shunting has emerged as a novel therapy for those with symptomatic HF despite optimal guideline-directed medical therapy. Initially thought of as a therapy reserved for those with diastolic HF, the field now spans the entire HF spectrum. In this review, we explore the physiology, devices, and trials that have shaped the field of atrial shunting. We detail how device-based interatrial shunts, no-implant interatrial shunts, and coronary sinus shunts aim to provide clinical benefit in specific patient populations and the limitations associated with their use.
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Spring et al. (2025) conducted a review in Heart Failure. Atrial shunting was evaluated. Atrial shunting has emerged as a novel therapy for symptomatic heart failure across the entire spectrum, utilizing device-based, no-implant, and coronary sinus shunts.
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