Organizational Model of the Heart Failure Outpatient Clinic at Aorn Cardarelli: From Acute Management to Therapeutic Optimization

Background Heart failure (HF) represents a significant clinical and economic burden, characterized by high rates of rehospitalization and mortality. Effective management requires a structured transition from acute care to specialized longitudinal follow–up. This abstract describes the organizational model of the Heart Failure Outpatient Clinic within the Cardiology and Intensive Coronary Care Unit (UTIC) at AORN Cardarelli (Naples, Italy). Materials and Methods Patients are enrolled directly following an Emergency Department (ED) visit with a specialist cardiological consultation, or post–discharge from the Cardiology/UTIC ward. A mandatory clinical protocol is required for the first visit: patients must present a recent Transthoracic Echocardiogram (TTE) and a comprehensive panel of blood tests, including NT–proBNP levels. The clinical workflow is designed to provide intensive monitoring, with follow–up appointments scheduled at 1–month, 3–month, and 6–month intervals, tailored to the clinical severity and hemodynamic stability of the individual patient. Results The implementation of this structured model allows for the systematic titration of Guideline–Directed Medical Therapy (GDMT). By utilizing standardized entry criteria (TTE and NT–proBNP), the clinic facilitates immediate risk stratification. A key outcome of this organizational structure is the identification of candidates for non–pharmacological interventions. Patients with persistent low ejection fraction (EF ‹ 35%) are channeled into dedicated pathways for the implantation of Implantable Cardioverter Defibrillators (ICD) or Cardiac Resynchronization Therapy (CRT–D/P). This proactive approach ensures that patients receive advanced device therapy at the optimal physiological window, potentially reducing the incidence of sudden cardiac death and worsening heart failure. Conclusions The organizational model of the Heart Failure Outpatient Clinic at AORN Cardarelli demonstrates that a streamlined transition from acute to outpatient care is essential for high–quality HF management. By integrating rigorous clinical monitoring with standardized diagnostic requirements, the clinic effectively bridges the gap between hospital discharge and long–term stability. This model not only optimizes pharmacological treatment but also serves as a critical screening hub for life–saving device implantation, ultimately aiming to improve patient survival and quality of life in a high–volume tertiary care setting.