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?

Dickstein, Kenneth; Normand, Camilla; Auricchio, Angelo; Bogale, Nigussie; Cleland, John G.F.; Gitt, Anselm K.; Stellbrink, Christoph; Anker, Stefan D.; Filippatos, Gerasimos; Gasparini, Maurizio; Hindricks, Gerhard; Lundqvist, Carina Blomström; Ponikowski, Piotr; Ruschitzka, Frank; Botto, Giovanni Luca; Bulava, Alan; Duray, Gabor Z.; Israel, Carsten W.; Leclercq, Christophe; Margitfalvi, P; Cano, Óscar; Plummer, Chris; Sarıgül, Nedim Umutay; Sterliński, Maciej; Linde, Cecilia

doi:10.1002/ejhf.1142

Cited by 117 publications

(131 citation statements)

References 32 publications

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“…Our results indicate that clinicians disregard this gap of evidence and continue to upgrade a large number of patients. Upgrades constituted 28% of the cohort 16 and the same percentage in the previous survey. 12 This proportion may indicate the firm belief by clinicians that CRT will be beneficial in these patient populations despite the absence of strong guideline indications.…”

Section: Discussionmentioning

confidence: 69%

Upgrades from a previous device compared to de novo cardiac resynchronization therapy in the European Society of Cardiology CRT Survey II

Linde

Normand

Bogale³

et al. 2018

European J of Heart Fail

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Background To date, there are no data from randomized controlled studies on the benefit of cardiac resynchronization therapy (CRT) when implanted as an upgrade in patients with a previous device as compared to de novo CRT. In the CRT Survey II we compared the baseline data of patients upgraded to CRT (CRT‐P/CRT‐D) from a previous pacemaker (PM) or implantable cardioverter‐defibrillator (ICD) to de novo CRT implantation. Methods and results In the European CRT Survey II, clinical practice data of patients undergoing CRT and/or ICD implantation across 42 European Society of Cardiology (ESC) countries were collected between October 2015 and December 2016. Out of a total of 11 088 patients, 2396 (23.2%) were upgraded from a previous PM or ICD and 7933 (76.8%) underwent de novo implantation. Compared to de novo implantations, upgraded patients were older, more often male, more frequently had ischaemic heart failure aetiology, atrial fibrillation, reduced renal function, worse heart failure symptoms, and higher N‐terminal pro‐B‐type natriuretic peptide levels. Upgraded patients were more often PM‐dependent and less frequently received CRT‐D. Total peri‐procedural, in‐hospital complications and length of hospital stay were similar. Upgraded patients were less frequently treated with heart failure medication at discharge. Conclusion Despite a lack of evidenced‐based data, close to one quarter of all CRT implantations across 42 ESC countries were upgrades from a previous PM or ICD. Despite older age and worse symptoms, the CRT implantation procedures in upgraded patients were equally frequently successful and complications similar to de novo implantations. These results call for more studies.

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Section: Discussionmentioning

confidence: 69%

Upgrades from a previous device compared to de novo cardiac resynchronization therapy in the European Society of Cardiology CRT Survey II

Linde

Normand

Bogale³

et al. 2018

European J of Heart Fail

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“…The lack of data from randomized controlled trials in patients with AF and CRT is surprising or even incomprehensible if we consider the importance of this population in CRT. According to different surveys or studies, about 25% of patients implanted with a CRT device have AF and CRT is recommended by the 2016 European Society of Cardiology guidelines on the management and treatment of heart failure for NYHA class III and IV AF patients with left ventricular ejection fraction <35% and QRS duration >130 ms if a strategy to ensure biventricular capture is in place, or if the patient is expected to return to sinus rhythm . The recommendations are based on limited evidence of efficacy of CRT in this specific population without dedicated randomized controlled trials.…”

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confidence: 90%

I had a dream…

Leclercq

Galand

Béhar

et al. 2018

European J of Heart Fail

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“…[88][89][90] Multiple predictors of the response to CRT have been identified. [88][89][90] Multiple predictors of the response to CRT have been identified.…”

Section: Devices Cardiac Resynchronization Therapymentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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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?

Cited by 117 publications

References 32 publications

Upgrades from a previous device compared to de novo cardiac resynchronization therapy in the European Society of Cardiology CRT Survey II

Upgrades from a previous device compared to de novo cardiac resynchronization therapy in the European Society of Cardiology CRT Survey II

I had a dream…

Highlights in heart failure

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