Review article sets the standard for training pathways in interventional heart failure

Interventional heart failure (IHF) has rapidly evolved as a critical subspecialty within cardiology at the crossroads of advanced heart failure and interventional cardiology. The increasing complexity of patient care—spanning both pharmacological treatments and an expanding array of device-based therapies—has underscored the urgent need for a standardized approach to training and career development in this field.

That's the message from experts in a comprehensive review, "Charting the Course for Careers in Interventional Heart Failure: Training, Challenges, Future Directions," highlighted at Technology and Heart Failure Therapeutics (THT) 2025 in Boston, MA. Co-published in JSCAI, the article highlights and addresses training gaps to advance the specialty, with an eye toward enabling future trainees to drive innovation and improve outcomes for patients with complex heart failure.

"Parallel to advances in pharmacological therapies for heart failure, there have been rapid advancements in device-based therapies. The intersection of heart failure and interventional cardiology has grown rapidly. Yet, there has been no formalized training pathway or clear consensus on what a career in this field should look like. Having specialists who not only understand heart failure but are also adept at interventional techniques is paramount to meeting the growing needs of our patients with heart failure," said co-author Richard Cheng, MD, FSCAI, assistant professor in the Division of Cardiology, Department of Medicine at the University of California, San Francisco.

"This article is a pivotal step towards establishing clear career paths, delineating competencies, and developing standardized training pathways essential for our specialty to thrive."

Career pathways

The article proposes a clear consensus on the different career phenotypes within IHF. These range from those with no formal interventional training who may perform endomyocardial biopsies, place pressure sensors, and implant some temporary mechanical circulatory support devices, to formally trained interventionalists focusing on coronary interventions and large-bore devices and specialists with structural training handling transcatheter valve therapies and related procedures.

Training pathways

The article proposes five core training focuses and outlines the essential competencies and components needed for effective training in IHF. This initiative aims to standardize the training process across the country, ensuring that future specialists are fully equipped to manage the unique challenges posed by advanced heart failure.

Future directions

The article highlights the potential for developing integrated training programs and specialized IHF sections within cardiology, further advancing the field, promoting research and innovation in related disciplines, and improving patient outcomes.

The publication of this comprehensive review marks a significant stride towards bridging device implantation and interventional procedures with hemodynamics, and further, clinical outcomes in the treatment of heart failure, the authors wrote. As the field of IHF continues to evolve, standardized training pathways will be essential to ensure specialists are well-prepared to deliver the highest standard of care to complex heart failure patients.

More information:
Charting the Course for Careers in Interventional Heart Failure: Training, Challenges, Future Directions, Journal of the Society for Cardiovascular Angiography & Interventions (2025). DOI: 10.1016/j.jscai.2025.102569

Provided by Society for Cardiovascular Angiography and Interventions