Criteria for receiving left ventricular assist devices as destination therapy

Centers for Medicare and Medicaid Services Criteria
New York Heart Association class IV (severe limitations)
Intra-aortic balloon pump (> 7 days) (or peak VO2 < 14 mL/kg/min)
No response to medical therapy
Left ventricular ejection fraction < 25%
Adequate right ventricular function
Major contraindications to heart transplant
Smoking cessation < 6 months
Substance dependency
Inadequate decision-making capacity
Irreversible pulmonary hypertension (> 5 Wood units)
Psychosocial issues
Other end-organ issues