The Heart Failure Clinic (CLIC)

Specialized multidisciplinary heart failure clinics play an essential role in patient follow-up. They offer educational support to both patients and families, ensure continuous adjustment of treatments, and provide a structured framework for guidance throughout the course of the disease. These clinics improve the quality of life of individuals living with heart failure, reduce hospitalizations, and even lower mortality.

They also encourage the active engagement of patients and their loved ones in their own care plan by providing the tools needed to recognize early signs of deterioration and to quickly apply a home emergency plan.

This support network contributes to improving quality of life and reducing the risk of complications.

Regular follow-up

Heart failure requires rigorous follow-up in an outpatient setting, comparable to ongoing medical monitoring.
The frequency of clinic visits varies according to symptoms and the progression of the condition.

In certain cases, appointments may be as frequent as once a week, depending on the clinical team’s evaluation.

How the clinic operates

The clinic operates by appointment.

The date and time of the first appointment are communicated by telephone or by mail.
Subsequent appointments are usually scheduled before leaving the clinic.

An appointment may occasionally be moved earlier if the health condition worsens, either at the request of the patient, their family, or the clinic.

Preparing for the visit

To help the team optimize follow-up, the following up-to-date information should always be brought to the appointment:

a complete list of medications, including recent changes,
the name and contact information (including fax number) of the family physician, specialists, and pharmacy,
recent home bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure readings,
daily weight measurements,
an approximate record of daily fluid intake,
any recent change in symptoms,
any hospitalization or emergency department visit since the last follow-up,
questions to be discussed during the visit.

What to Expect During an Appointment

The first appointment is used to review medical history and identify risk factors (such as smoking, sleep apnea, diabetes, cholesterolCholesterol is essential for the proper functioning of the human body, but it can also have harmful effects if present in excess. >>, etc.).

Subsequent visits usually include bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood tests, questions about symptoms, and a physical examination that may involve:

blood pressure measurement,
pulseThe pulse is the sensation of beating that one feels by applying slight pressure on an artery, usually at the wrist or neck. It corresponds to the blood flow pulsated by the heart through the arteries with and oxygen saturation,
weight,
lung and heart auscultation,
assessment of the neck veins.

Additional tests may be ordered if needed.

Medications may be adjusted to help the heart function more effectively, improve quality of life, prevent hospitalizations, and increase life expectancy — even when symptoms appear stable.

Refining the Diagnosis When Needed

The heart failure clinic can also be the place where less common forms of heart failure are investigated more thoroughly.
In this context, specialized tests or specific bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood work may be required to clarify the diagnosis.

A genetic evaluation may be considered when a familial or hereditary cause is suspected.
Reviewing family history — including previous generations — along with targeted testing can help guide management.

These investigations may lead to treatments that are better suited to the identified cause, as well as preventive screening recommendations for family members.

Preventing a Potentially Life-Threatening Arrhythmia

Patients with heart failure and a left ventricular ejection fraction (LVEF) of 35% or less after optimized medical therapy have an increased risk of serious arrhythmias, such as ventricular tachycardia or ventricular fibrillation.

When the LVEF remains below this threshold despite optimal management — including medication and non-pharmacological measures — these patients may be referred for the implantation of an implantable cardioverter-defibrillator (ICD).

In certain specific situations, an ICD may also be considered for patients whose LVEF is greater than 35%, but who have particular types of heart failure associated with a high risk of life-threatening arrhythmias.

An ICD is a small device implanted under the skin, usually in the upper left chest, beneath the collarbone. It can be viewed as an advanced version of a pacemaker.

Like a pacemaker, it can stimulate the heart when the heart rate becomes too slow. However, its primary role is the continuous monitoring of heart rhythm, with the ability to intervene immediately if a dangerous arrhythmia occurs.
If a disorganized rhythm is detected, the device delivers an electrical impulse to restore a normal rhythm — an intervention that can be lifesaving.

See also: Implantable Defibrillator.

First Contact With the Palliative Care Team

The term palliative care can create concern for both patients and their families, as it is often associated with the very end of life. However, in the context of heart failure, the term supportive care is often more appropriate.

This chronic and progressive condition requires care that is adapted to each stage. Understanding the role of palliative and supportive care helps improve quality of life and anticipate needs as the disease advances.

Heart failure clinics include a multidisciplinary team and promote this type of global approach, supporting the patient throughout the entire course of the illness, relieving symptoms, and helping to ease daily life.

Between Appointments

The clinic should be notified promptly in the event of:

increased shortness of breath,
swelling of the legs or abdomen,
waking up at night short of breath,
a weight gain of 2–3 kg (4–7 lbs) over 3 to 5 days,
general worsening of symptoms,
or according to any other instructions provided by the care team.

Other Important Information

Any change of address and/or telephone number should be communicated to the clinic to ensure that contact information remains up to date.

Collaboration With Other Healthcare Professionals

A summary of the follow-up performed at the heart failure clinic may be sent to the family physician and to other specialists involved in the patient’s care, ensuring coordinated and consistent management.