Utilization of cardiac resynchronization therapy in patients with heart failure in the Northern Region of New Zealand

Abstract

BackgroundCardiac resynchronization therapy (CRT) has been shown to improve morbidity and mortality for heart failure (HF) patients. Little is known about the trends in CRT use and outcomes of these patients in New Zealand.MethodMortality, hospitalization events and complications in HF patients in the Northern Region of New Zealand implanted with CRT devices from Jan‐2007 to June‐2015 were reviewed.ResultsTwo‐hundred patients underwent CRT implantation during the study period. There was a gradual increase in CRT‐D implantation (n = 157) but the number remained static for CRT‐P (n = 43). Patients who received CRT‐P were older (mean age 65.9 ± 14.0 years vs 61.5 ± 10.2 years, P < 0.0007) but had a higher left ventricular ejection fraction (LVEF) (33.7 ± 10.5% vs 24.7 ± 6.1%, P < 0.0001) than those undergoing CRT‐D implant procedures. During a median follow‐up of 4 (2.8) years, 29 (14.5%) patients (14.7% in CRT‐D vs 13.9% in CRT‐P, P = 0.91) had died. HF was the cause of death in 73.9% of the patients. There was no difference in all‐cause mortality between patients with CRT‐D and CRT‐P.ConclusionsDespite the proven benefits of CRT in selected HF patients, there continued to be under‐utilization of these devices in HF patients in the Northern Region. Reasons for under‐utilization of these devices need further exploration. These data should be useful for benchmarking individual patient management and national practice against wider experience in the country.

Impact of cardiac resynchronisation therapy on burden of hospitalisations and survival: a retrospective observational study in the Northern Region of New Zealand

“…This was a single-centre, retrospective observational study with relatively low sample size. We have recently published trends of CRT therapy use for eligible patients with HF in New Zealand and the data suggests that there is a significant unmet clinical need for CRT implantation in the Northern Region 30. Affordability and capacity are of concern in this region.…”

Moxibustion Improves Chronic Heart Failure by Inhibiting Autophagy and Inflammation via Upregulation of mTOR Expression

“…Chronic heart failure (CHF) is the ultimate outcome of different cardiovascular diseases, which represents a public health problem requiring urgent attention all over the world due to its high morbidity, mortality, and rehospitalization rates [ 1 , 2 ]. The 2018 China Cardiovascular Diseases Report indicated that the number of patients with cardiovascular disease exceeded 200 million, and patients with heart failure accounted for 2%.…”

Utilization and Efficacy of Cardiac Resynchronization Therapy in Patients With Chronic Heart Failure ― A Report From the CHART-2 Study ―

“…However, recent studies in European countries have shown that the utilization rate of CRT for eligible CHF patients was only approximately 30%. 8, 9 In Japan, although the number of CHF patients has been increasing, as in the Western countries, 10,11 there has been no change in the number of new implantations or replacements of CRT. 12 In Japan, limited data are available on CRT utilization and long-term D evice therapy, including implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT), has been shown to improve morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF).…”