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Focus on France

September 2020

ACVC National Representative

CHU MONTPELLIER Prof. Francois Roubille
Unité de soins intensifs cardiologiques-Intensive care unit
Département de Cardiologie-Cardiology Department,
Montpellier, France
Past-President of the USIC

ACVC Young National Representative

Clement Delmas.jpg Dr. Clement Delmas
Toulouse, France
Secretary of the USIC



What does it mean to be an ACVC National Representative?

To my mind, this is the best way to be in touch with the European projects and be a link between the national group and the ACVC. The national equivalent of the ACVC is part of the French Cardiac Society (Société Française de Cardiologie)

The current president is Prof. Puymirat (Paris, France) and its secretary is Dr. Delmas (Toulouse, France).

Dr. Delmas is also the ACVC French young representative. The link is then natural.

Our role is to inform the national leaders and our national group of the ACVC's activities, from training to collaborative research networks.

What can ACVC bring to your national working group and vice-versa?

A crucial element is the ACVC is not well-know among colleagues, and sometimes they don’t understand it's a part of the European Society of Cardiology and not the ESC itself. We think training and educational programmes can be widely shared.

For instance, our group translated in French the ACVC Clinical-Decision Making Toolkit in tight collaboration with the ACVC, under the overview of Prof. Bonnefoy-Cudraz (Lyon, France). This French version is especially useful in clinical practice, especially for the youngest, and is a good way for us to promote the ACVC.

The ACVC particiapted in the 2019 French cardiology congress in Paris where 600 participants came. Its presence was appreciated, especially thanks to the toolkit distribution.

Conversely, the national group would be glad to be more involved in the ACVC's activities, from the congress (programmes, speakers…) to educational and research activities (especially collaborative projects including surveys and clinical research).

What does an ICCU look like in your country?

In France, the ICCUs are most often under the overview of a cardiologist. In a nationwide study, we described the ICCUs extensively in 2017 1, 2. See for more details Figures and Tables 1-8.

Access figures 

Describe the most challenging situation in your country

As explained above, the ICCUs have deeply changed in the past decades, and national guidelines would help for a better organisation and implementation of international guidelines. Clearly, there are some heterogeneities among territories, and the network organisation as recommended in the ESC Guidelines remain challenging. Even if this is already implemented for “simple” situations such as non-complicated acute coronary syndromes, this is to improve locally regarding more complex situations especially cardiogenic shock. That’s the reason why our group has worked on a nation-wide registry. More than 750 patients have been included and this work is currently submitted for publication.

What would you like to change or harmonise?

Our group is eager to participate more in ACVC activities. Guidelines on the requirements for doctors to work in ICCUs are relatively clear. Similar approaches would be of interest for paramedics and a dedicated curriculum homogenised at European level but adapted to national context would be of high interests.

European surveys could be compared to national levels to enable us to draw conclusions with translations into practice. For instance, we led a national survey on the ICCU workers, with the aim to compare with the ACVC survey in a near future but above all to propose practical improvements. Briefly, educational improvements, especially for the youngest junior doctors involved in the ICCUs, were the first requirement.


  1. Roubille F, Mercier G, Delmas C, Manzo-Silberman S, Leurent G, Elbaz M, Riondel A, Bonnefoy-Cudraz E and Henry P. Description of acute cardiac care in 2014: A French nation-wide database on 277,845 admissions in 270 ICCUs. Int J Cardiol. 2017;240:433-437.
  2. Roubille F, Mercier G, Delmas C, Manzo-Silberman S, Leurent G, Elbaz M, Riondel A, Bonnefoy-Cudraz E, Henry P and French group of Iccu MotSFdCMotAaMotESC. Data on nation-wide activity in intensive cardiac care units in France in 2014. Data Brief. 2017;13:166-170.
  3. Roubille F, Bonnefoy E, Puymirat E, Elbaz M, Henry P and Usic Group amotSfdctACVCtESoC. How should we implement the recommendations of the Acute Cardiovascular Care Association in intensive cardiac care units in France? Arch Cardiovasc Dis. 2019;112:79-81.
  4. Bonnefoy-Cudraz E, Bueno H, Casella G, De Maria E, Fitzsimons D, Halvorsen S, Hassager C, Iakobishvili Z, Magdy A, Marandi T, Mimoso J, Parkhomenko A, Price S, Rokyta R, Roubille F, Serpytis P, Shimony A, Stepinska J, Tint D, Trendafilova E, Tubaro M, Vrints C, Walker D, Zahger D, Zima E, Zukermann R and Lettino M. Editor's Choice - Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function. Eur Heart J Acute Cardiovasc Care. 2018;7:80-95.
  5. Delmas C, Puymirat E, Leurent G, Elbaz M, Manzo-Silberman S, Bonello L, Gerbaud E, Bataille V, Levy B, Lamblin N, Bonnefoy E, Henry P, Roubille F and investigators F. Design and preliminary results of FRENSHOCK 2016: A prospective nationwide multicentre registry on cardiogenic shock. Arch Cardiovasc Dis. 2019;112:343-353.