학술논문

CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients-who is doing what to whom and how?
Document Type
Journal Article
Source
European Journal of Heart Failure. Jun2018, Vol. 20 Issue 6, p1039-1051. 13p. 6 Charts, 1 Graph.
Subject
*CARDIAC pacing
*CARDIAC pacemakers
*HEART failure
*HEART failure patients
*HEART failure treatment
*CARDIOLOGY
*COMPARATIVE studies
*DISEASES
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*MEDICAL protocols
*MEDICAL societies
*PROGNOSIS
*RESEARCH
*SURVIVAL
*EVALUATION research
Language
ISSN
1388-9842
Abstract
Background: Cardiac resynchronisation therapy (CRT) reduces morbidity and mortality in appropriately selected patients with heart failure and is strongly recommended for such patients by guidelines. A European Society of Cardiology (ESC) CRT survey conducted in 2008-2009 showed considerable variation in guideline adherence and large individual, national and regional differences in patient selection, implantation practice and follow-up. Accordingly, two ESC associations, the European Heart Rhythm Association and the Heart Failure Association, designed a second prospective survey to describe contemporary clinical practice regarding CRT.Methods and Results: A survey of the clinical practice of CRT-P and CRT-D implantation was conducted from October 2015 to December 2016 in 42 ESC member countries. Implanting centres provided information about their hospital and CRT service and were asked to complete a web-based case report form collecting information on patient characteristics, investigations, implantation procedures and complications during the index hospitalisation. The 11 088 patients enrolled represented 11% of the total number of expected implantations in participating countries during the survey period; 32% of patients were aged ≥75 years, 28% of procedures were upgrades from a permanent pacemaker or implantable cardioverter-defibrillator and 30% were CRT-P rather than CRT-D. Most patients (88%) had a QRS duration ≥130 ms, 73% had left bundle branch block and 26% were in atrial fibrillation at the time of implantation. Large geographical variations in clinical practice were observed.Conclusion: CRT Survey II provides a valuable source of information on contemporary clinical practice with respect to CRT implantation in a large sample of ESC member states. The survey permits assessment of guideline adherence and demonstrates variations in patient selection, management, implantation procedure and follow-up strategy. [ABSTRACT FROM AUTHOR]