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Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
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OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Mr Nigussie Bogale,
List of Authors: Nigussie Bogale, Silvia Priori, John GF Cleland, Josep Brugada,Cecilia Linde, Angelo Auricchio, Dirk J van Veldhuisen, Tobias Limbourg, Anselm Gitt, Daniel Gras, Christoph Stellbrink, Maurizio Gasparini, Marco Metra, Geneviève Derumeaux, Fredrik Gadler, Laszlo Buga and Kenneth Dickstein
Aims: The European CRT Survey is a joint initiative of the Heart Failure (HFA) and the European Heart Rhythm (EHRA) Associations of the European Society of Cardiology evaluating the contemporary implantation practice of Cardiac Resynchronization Therapy (CRT) in Europe. Methods and Results: Patients who had a successful CRT implantation were enrolled from 141 centres in 13 countries between November 2008 and June 2009. Baseline demographics, clinical and implantation data were collected with a follow-up of approximately one year (9-15 months). The current report describes clinical outcomes including symptom severity, cardiovascular (CV) hospitalization and survival. 2438 patients were enrolled and follow-up data acquired from 2111 patients (87 %). The population included important groups of patients poorly represented in RCTs, including very elderly patients and those with prior device implantation, atrial fibrillation and/or QRS duration < 120 msec. Investigators reported substantial improvement in NYHA functional class at follow-up. Patient self-assessment indicated that 81 % of the patients felt improved, 16 % reported no change and 4 % reported deterioration. During follow-up, 207 (10 %) patients died, 346 (16 %) had a CV hospitalization and 501 (24 %) died or had CV hospitalization. Worse NYHA functional, atrial fibrillation, ischaemic aetiology and device type (CRT-P) were associated with poorer survival. Women had a better outcome as did patients who had a CRT-D device. Conclusions: Outcomes including death and hospitalization in this European CRT survey were consistent with results from clinical trials of CRT. At one year follow-up, most patients who received a CRT device considered their symptoms improved compared to their pre-implant assessment. Although prospective, this is an observational study of successful CRT implantations and outcomes in subgroup analyses must be interpreted with appropriate conservatism.
Clinical Registry Highlight II - Interventions and devices
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