The final stage of heart failure is stage D, which is sometimes referred to as refractory end-stage heart failure, according to eMedicineHealth. Stage D heart failure is characterized by heart failure symptoms experienced when the patient is at rest, even when receiving medical treatment.
The treatment for stage D heart failure generally involves the implantation of mechanical cardiac devices, including defibrillators or pacemakers, heart transplant, or other types of aggressive medical therapy, notes eMedicineHealth. End-of-life care may also be a final option to keep the patient comfortable and reduce symptoms for improved quality of life.
Congestive heart failure surgery to repair the underlying cause of the heart failure may be necessary, notes eMedicineHealth. Coronary artery bypass graft surgery is sometimes done, allowing the heart muscle to maintain a sufficient blood supply while bypassing blockages that cause the heart to work less efficiently. Left ventricular assist devices are also a possibility. These devices are implanted during surgery, and they work to bypass the left ventricle mechanically, sometimes as a means to keep the heart functioning properly until a heart transplant can be done. An artificial heart is sometimes transplanted while a patient is waiting on an available donor heart, although the technique is still experimental and not widely available as of 2015.