What type of device therapy is NOT currently approved for patients with HFrEF?

The correct answer highlights that pacemakers for bradycardia are not specifically approved as a device therapy for patients with Heart Failure with Reduced Ejection Fraction (HFrEF). While pacemakers are indeed used in various situations, their primary role is to manage bradycardia—a condition characterized by a slower than normal heart rate. In HFrEF, pacemakers are not considered a direct treatment option for the heart failure itself.

On the other hand, cardiac resynchronization therapy (CRT) and implantable cardiac defibrillators (ICD) are specifically designed to manage symptoms and improve outcomes in patients with HFrEF. CRT helps coordinate the contractions of the heart’s chambers in patients with both heart failure and electrical conduction issues, while ICDs are utilized to prevent sudden cardiac death in at-risk individuals. Hence, both CRT and ICDs have important and established roles in the management of heart failure patients, particularly in those with HFrEF.

In summary, the distinction lies in the specific purpose and approval of the devices: CRT and ICD are directly related to heart failure management, while pacemakers for bradycardia address a different cardiac issue and are not classified as a primary treatment for HFrEF.