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Patients that have cardiomyopathy can also benefit from non-pharmacological treatments. What are they? They include what we call pacemakers, if they have conduction system disease. In some of the infiltrative cardiomyopathies, the heart starts to slow down and the heart rate is too slow to keep up with the body’s metabolic demands. And those patients can benefit from a pacemaker. But if the heart muscle is weak and the ejection fraction, which is the ability or the squeeze of the heart with each beat, is less than 35% or equal, those patients can benefit from a defibrillator, because defibrillators have been shown to do only one thing, which is improve survival from sudden death in patients with cardiomyopathy. Now, importantly, patients that have cardiomyopathy often have scarring of the heart, and the scarring leads to desynchronization where the right ventricle and the left ventricle are not contracting in sequence. And there’s a little bit of delay in mismatch, which works against each other. So there is what they call cardiac resynchronization therapy, where leads are put in both ventricles to basically pace both ventricles simultaneously so that they squeeze at the same time, rather dissynchronously. And this is called cardiac resynchronization therapy, which often helps symptoms and sometimes helps improvement of the weakening of the muscle of the heart.
