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Significant differences regarding in-hospital survival were observed between the devices (survival overall 40.2%; medical treatment = 39.5%; IABP = 49.5%; pVAD = 36.2%; VA-ECMO = 30.5%; p  0.001). The incidence of CS is increasing, but hospital survival remains low. MCS was used in a minority of patients, and the percentage of MCS usage in CS has decreased. The use rates of the competing devices change over time. The incidence of CS is increasing, but hospital survival remains low. MCS was used in a minority of patients, and the per