HEART FAILURE: Edited by Frank W. SmartNovel technologies in the management of heart failure with preserved ejection fraction: a promise during the time of disappointment from pharmacological approaches?Nachman, Deana,b; Asleh, Rabeaa,b; Amir, Offerb,cAuthor Information aFaculty of Medicine, The Hebrew University of Jerusalem bHeart Institute, Hadassah Medical Center, Jerusalem cAzrieli Faculty of Medicine, Bar-Ilan University, Zfat, Israel Correspondence to Dr Dean Nachman, MD, Heart Institute, Hadassah Medical Center, POB 12272, Jerusalem, 91120, Israel. Tel: +972 50 2217665, +972 2 6757657; fax: +972 2 6757660; e-mail: [email protected] Current Opinion in Cardiology: March 2021 - Volume 36 - Issue 2 - p 211-218 doi: 10.1097/HCO.0000000000000829 Buy Metrics Abstract Purpose of review Despite numerous attempts, none of a wide variety of tested drugs achieved meaningful improvement in the outcomes of heart failure with preserved ejection fraction (HFpEF), making new therapeutic strategies a major unmet medical need. The medical device industry embraced the challenge, developing novel technologies directed to face specific aspects of the pathophysiology of HFpEF. This review focuses on some of the most promising technologies attaining meaningful clinical progress recently in the field of HFpEF therapy. Recent findings Implantable pulmonary artery pressure, monitoring for optimization of medical therapy, proved to be beneficial in heart failure admissions in a large postmarketing clinical study. Investigational devices, such as inter-atrial shunts and transvenous phrenic nerve stimulators for the treatment of central sleep apnea with Cheyne–Stokes breathing, are currently being evaluated in HFpEF cohorts in recent trials. Summary Device-based therapies for HFpEF demonstrated encouraging safety and efficacy results in various stages of the disease. Further efforts are needed to ensure that these devices will reach clinical use and contribute to the management of HFpEF patients. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.