Table 3. Clinical criteria of referral for advanced HF.

Repeated hospitalization or urgent visit of emergency department within past year

Persistent NYHA functional class III or IV symptoms

Intolerance of GDMT

Need of inotropic agent to relieve HF symptoms

Refractory congestion despite medical therapy needing escalation of diuretic dose

Persistent or progressive organ failure including renal, hepatic dysfunction

Recurrent episodes of ventricular arrhythmia or appropriate ICD shocks

Persistent or frequent hypotension (SBP ≤90 mmHg)

Persistent hyponatremia

Non-responder of CRT

CRT = cardiac resynchronization therapy; GDMT = guideline-directed medical therapy; HF = heart failure; ICD = implantable cardioverter defibrillator; NYHA = New York Heart Association; SBP = systolic blood pressure.