TABLE 2.

Treatment for transthyretin‐related amyloidosis and its comorbidities and complications

Medical treatment for ATTR	Invasive treatment for end‐stage ATTR	Treatment for comorbidities and complications
Inhibitors of TTR gene expression Tetramer stabilizers Inhibitors of oligomer aggregation and disruption Inhibitors of degradation and reabsorption of amyloid fibers	Left ventricular assist device and heart transplant (only if no extracardiac involvement) Liver transplantation Combined liver‐heart transplantation	1. Heart failure a) Medical treatment Diuretics Beta blockers Angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers (Nondihydropyridine calcium channel blockers are contraindicated due to their negative inotropic effect.) b) Left ventricular assist device: bridging for heart transplant 2. Atrial fibrillation Role of anticoagulation is unclear Cardioversion remains a reasonable treatment option 3. Life‐threatening arrhythmia a) ICD Role of ICD as primary prevention of sudden cardiac death unclear given lack of overall survival benefit b) Cardiac pacing Indication of PPM placement is the same as current guideline Limited evidence of survival benefit

Abbreviations: ATTR, transthyretin‐related amyloidosis; ICD, implantable cardioverter‐defibrillator; PPM, permanent pacemaker; TTR, transthyretin.