New subspecialty to focus on advanced heart failure, transplantation

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The new medical subspecialty of Advanced Heart Failure and Transplant Cardiology could provide technically advanced yet cost-effective care for patients with heart failure, according to a perspective article in the March issue of the Journal of Cardiac Failure.

"First and foremost, this action represents an essential advance for patients with heart failure and their families," wrote Marvin A. Konstam, MD, of Tufts Medical Center in Boston, and colleagues.

The proposal to establish the new subspecialty, originated by the Heart Failure Society of America (HFSA), was approved late last year by the American Board of Medical (ABIM) Specialties. The first Advanced Heart Failure and Transplant Cardiologists will be certified in 2010.

The new specialty arose because of the progress in treatment options for patients with heart failure, such as heart transplantation and ventricular assist devices, the authors said.

"As a result, a subspecialty has arisen de facto, with more than 40 cardiology programs in the United States providing training in the area of advanced heart failure and a growing number of individual cardiologists offering a varying spectrum of expertise," Konstam and colleagues wrote.

While most heart failure patients will continue to be managed by general internists or cardiologists, the new subspecialists will serve as consultants for patients with worsening heart failure and those who need more advanced care, according to the authors. Advanced Heart Failure and Transplant Cardiologists will also play a role as leaders of specialized services, such as transplant centers and heart failure clinics. They will be cardiologists with experience in managing the spectrum of patients with heart failure and expanding range of treatment techniques.

For the first five years, cardiologists who can document high-level experience in Advanced Heart Failure and Transplant Cardiology will be qualified to sit for the certifying exam. After that, one-year accredited training programs will be available for physicians after they have earned their board certification in cardiovascular disease through the ABIM.

"This perspective, authored by several of the leaders who developed and shepherded the certification process to its successful culmination, highlights the rationale for formalizing training the training process for specialists in this field and the requirements for certification," said Barry M. Massie, MD, editor-in-chief of the Journal of Cardiac Failure.