Currently, there is a worldwide pandemic of heart failure, and its medical management has been targeted in the current era to prevent the progression of the disease and to reduce the number of deaths from advanced heart failure. As the other aspect, the application of ventricular assist devices as a bridge to transplantation or destination therapy has been well accepted, and the paradigm of end-stage heart failure management has been changed. In this report, we have reviewed the new developments in the treatment of advanced heart failure divided into conventional treatment and how to respond to the issues raised by the advances in diagnostic modalities. Among the newly developed evaluation methods for advanced heart failure, biomarkers such as genetic information, electrocardiogram information (complete left bundle branch block), global longitudinal strain (GLS) on echocardiography, delayed myocardial contrast enhancement on MRI, and BNP are attracting attention. TcMIBI myocardial scintigraphy has been also introduced as the new modality.