High-dose carvedilol therapy for mechanical circulatory assisted patients.

Left ventricular assist devices are increasingly being used as a "bridge to recovery" in the clinical arena. However, the percentage of patients who can be weaned off these devices is still low. Carvedilol is an anti-heart failure agent that is used to induce cardiac reverse remodeling, and its effect is reportedly dose-dependent. In this study, we conducted high-dose carvedilol therapy (80 mg daily) in five patients who wore left ventricular assist devices. Three of the five patients showed an increase in cardiac function after this therapy, and one patient was successfully weaned off his device. No major adverse events were observed. The high-dose carvedilol therapy was found to be a safely tolerated intervention that may have enhanced the reverse remodeling of the failing heart in patients with left ventricular assist devices.