| • Absolute indications in appropriate patients
|
| For haemodynamic compromise due to heart failure |
| Refractory cardiogenic shock |
| Documented dependence on iv inotropic support to maintain adequate organ perfusion |
| Peak Vo2 <10 ml/kg/min with achievement of anaerobic metabolism |
| Severe symptoms of ischaemia that constantly limit routine activity and are not amenable to coronary artery bypass surgery or percutaneous coronary intervention |
| Recurrent symptomatic ventricular arrhythmias refractory to all therapeutic modalities |
| |
| • Relative indications
|
| Peak Vo2 11–14 ml/kg/min (or 55% of predicted) and major limitation of patient's daily activities |
| Recurrent unstable ischaemia not amenable to other intervention |
| Recurrent instability of fluid balance/renal function not due to patient non‐compliance with medical regimen |
| |
| • Insufficient indications
|
| Low left ventricular ejection fraction |
| History of functional class III or IV symptoms of heart failure |
| Peak Vo2 >15 ml/kg/min (and >55% of predicted) without other indications |
