Abstract
Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and all-cause mortality. Nevertheless, up to two-thirds of eligible patients are not referred for CRT. Furthermore, post-implantation follow-up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three European Society of Cardiology Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and European Association of Cardiovascular Imaging (EACVI), focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post-procedural care by focusing on four actionable domains: (i) overcoming CRT under-utilization, (ii) better understanding of pre-implant characteristics, (iii) abandoning the term 'non-response' and replacing this by the concept of disease modification, and (iv) implementing a dedicated post-implant CRT care pathway.
| Original language | English |
|---|---|
| Pages (from-to) | 2349-2369 |
| Number of pages | 21 |
| Journal | European journal of heart failure |
| Volume | 22 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2020 |
Keywords
- Cardiac resynchronization therapy
- Response
- Heart failure
- Implementation
- Utilization
- Care pathways
- Disease modification
- Disease management
- Outcome
- IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
- PERMANENT ATRIAL-FIBRILLATION
- EXPERT CONSENSUS STATEMENT
- REDUCED EJECTION FRACTION
- NONSUSTAINED VENTRICULAR-TACHYCARDIA
- ATRIOVENTRICULAR JUNCTION ABLATION
- ANGIOTENSIN-NEPRILYSIN INHIBITION
- BUNDLE-BRANCH BLOCK
- 2016 ESC GUIDELINES
- LONG-TERM OUTCOMES
Access to Document
- 10.1002/ejhf.2046Licence: CC BY-NC
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In: European journal of heart failure, Vol. 22, No. 12, 12.2020, p. 2349-2369.
Research output: Contribution to journal › Editorial › Academic › peer-review
TY - JOUR
T1 - Optimized implementation of cardiac resynchronization therapy
T2 - a call for action for referral and optimization of care A joint position statement from the Heart Failure Association (HFA), European Heart Rhythm Association (EHRA), and European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology
AU - Mullens, Wilfried
AU - Auricchio, Angelo
AU - Martens, Pieter
AU - Witte, Klaus
AU - Cowie, Martin R.
AU - Delgado, Victoria
AU - Dickstein, Kenneth
AU - Linde, Cecilia
AU - Vernooy, Kevin
AU - Leyva, Francisco
AU - Bauersachs, Johann
AU - Israel, Carsten W.
AU - Lund, Lars H.
AU - Donal, Erwan
AU - Boriani, Giuseppe
AU - Jaarsma, Tiny
AU - Berruezo, Antonio
AU - Traykov, Vassil
AU - Yousef, Zaheer
AU - Kalarus, Zbigniew
AU - Cosedis Nielsen, Jens
AU - Steffel, Jan
AU - Vardas, Panos
AU - Coats, Andrew
AU - Seferovic, Petar
AU - Edvardsen, Thor
AU - Heidbuchel, Hein
AU - Ruschitzka, Frank
AU - Leclercq, Christophe
N1 - Funding Information: W.M.: has received research grants from Novartis, Vifor, Medtronic, Biotronik, Abbott and Boston Scientific. A.A. is a consultant to Boston Scientific, Backbeat, Biosense Webster, Cairdac, Corvia, Microport CRM, Philips, Radcliffe Publisher; received speaker fees from Boston Scientific, Medtronic, and Microport; participates in clinical trials sponsored by Boston Scientific, Medtronic, Philips; has intellectual properties with Boston Scientific, Biosense Webster, and Microport CRM. P.M. has received a research grant from Vifor pharma and Fonds Wetenschappelijk Onderzoek (grant number: 1127917N) and consultancy fees from AstraZeneca, Bayer, Boehringer Ingelheim, Novartis and Vifor pharma. K.W.: consultancy fees and speaker fees from Medtronic, Abbott, Microport, Cardiac Dimensions, Bristol‐Myers Squibb, Pfizer, Bayer, AstraZeneca, and has received unconditional research support in the form of a PhD Fellowship collaboration between the University of Leeds and Medtronic UK. M.C. is a consultant to Boston Scientific, Medtronic, Abbott, Fire1Foundry, Neurotronik, Servier, Bayer, Novartis, and AstraZeneca. Imperial College London receives research grants from Abbott, Medtronic, Boston Scientific, Bayer and ResMed. V.D. has received speaker fees from Abbott Vascular, Edwards Lifesciences, GE Healthcare and Medtronic. The Department of Cardiology of the Leiden University Medical Center has received unrestricted research grants from Abbott Vascular, Bayer, Bioventrix, Biotronik, Boston Scientific, Edwards Lifesciences, GE Healthcare and Medtronic. K.D. has received research support from Medtronic, Boston Scientific, Biotronik, Abbott and Sorin. C.L.: research grants to institution from AstraZeneca, Swedish Heart‐Lung Foundation and Stockholm County Council. Speaker honoraria from Medtronic, Abbott, Microport, Boston Scientific, Novartis, Vifor, Impulse Dynamics, Bayer. K.V. has received consultancy and speaker fees from Medtronic, Abbott, and Phillips. The department has received research and educational grants from Medtronic, Abbott and Biotronik. F.L. is a consultant to Medtronic, Abbott, Boston Scientific, Microport and Novartis; has received research funding from Medtronic, Abbott, Boston Scientific, Microport. J.B.: related to the present work, none. Unrelated to the present work: honoraria for lectures and/or consulting: Novartis, BMS, Pfizer, Vifor, Bayer, Servier, CVRx, MSD, Boehringer Ingelheim, AstraZeneca, Abiomed, Abbott, Medtronic; research support: Zoll, CVRx, Bayer, Vifor, Abiomed, Medtronic. C.I.: consulting (advisory board): Medtronic; honoraria for presentations, travel/congress cost reimbursement; Abbott, Biotronik, Boston Scientific, Medtronic, MicroPort, Novartis; grants or research support: MicroPort. L.L. reports personal fees from Merck, Sanofi, Bayer, Pharmacosmos, Abbott, Medscape, Myokardia, grants and personal fees from Vifor‐Fresenius, AstraZeneca, Relypsa, Novartis, Mundipharma, Boehringer Ingelheim, grants from Boston Scientific, outside the submitted work. G.B. reports speaker's fees of small amount from Boston, Biotronik, Boehringer, Medtronic. T.J. has received consultation from Novartis. A.B. has received speaker fees and research grant from Biosense; has intellectual properties with Galgo Medical; participates in clinical trials sponsored by Biotronik, Biosense and Circle. V.T. has received consultancy and speaker honoraria from Medtronic, Pfizer, Berlin Chemie Menarini and Sandoz. Z.K.: none. J.C.N. has received grants from the Novo Nordisk Foundation (NNF16OC0018658 and NNF17OC0029148). J.S. has received consultant and/or speaker fees from Abbott, Amgen, AstraZeneca, Bayer, Biosense Webster, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol‐Myers Squibb, Daiichi Sankyo, Medscape, Medtronic, Merck/MSD, Novartis, Pfizer, Sanofi‐Aventis, WebMD, and Zoll; reports ownership of CorXL; has received grant support through his institution from Abbott, Bayer Healthcare, Biosense Webster, Biotronik, Boston Scientific, Daiichi Sankyo, and Medtronic. P.V. reports personal fees from Menarini International, Dean Medicus, Servier, European Society of Cardiology, Bayer and Hygeia Hospitals Group, outside the submitted work. A.C. declares having received honoraria and/or lecture fees from Astra Zeneca, Bayer, Menarini, Novartis, Nutricia, Servier, Vifor, Actimed, Cardiac Dimensions, CVRx, Enopace, Faraday, Gore, Impulse Dynamics, Respicardia, Stealth Peptides, V‐Wave, Corvia, Arena, ESN Cleer. P.S. has received consultancy fees and or speaker fees from Medtronic, Abbott, Servier, AstraZeneca, Respicardia, Boehringer Ingelheim, Novartis and Vifor Pharma. T.E.: none. H.H.: no personal disclosures. His institutions receive unconditional research grants from Medtronic, Daiichi Sankyo, Boehringer Ingelheim, Bayer, Pfizer‐BMS, Biotronik, Abbott and Bracco Imaging. F.R.: no personal disclosures. C.L.: no personal disclosures. Conflict of interest: Publisher Copyright: © the Author(s) 2020. This article has been co-published with permission in European Journal of Heart Failure (published by John Wiley & Sons Ltd on behalf of European Society of Cardiology) and EP Europace
PY - 2020/12
Y1 - 2020/12
N2 - Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and all-cause mortality. Nevertheless, up to two-thirds of eligible patients are not referred for CRT. Furthermore, post-implantation follow-up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three European Society of Cardiology Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and European Association of Cardiovascular Imaging (EACVI), focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post-procedural care by focusing on four actionable domains: (i) overcoming CRT under-utilization, (ii) better understanding of pre-implant characteristics, (iii) abandoning the term 'non-response' and replacing this by the concept of disease modification, and (iv) implementing a dedicated post-implant CRT care pathway.
AB - Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and all-cause mortality. Nevertheless, up to two-thirds of eligible patients are not referred for CRT. Furthermore, post-implantation follow-up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three European Society of Cardiology Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and European Association of Cardiovascular Imaging (EACVI), focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post-procedural care by focusing on four actionable domains: (i) overcoming CRT under-utilization, (ii) better understanding of pre-implant characteristics, (iii) abandoning the term 'non-response' and replacing this by the concept of disease modification, and (iv) implementing a dedicated post-implant CRT care pathway.
KW - Cardiac resynchronization therapy
KW - Response
KW - Heart failure
KW - Implementation
KW - Utilization
KW - Care pathways
KW - Disease modification
KW - Disease management
KW - Outcome
KW - IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
KW - PERMANENT ATRIAL-FIBRILLATION
KW - EXPERT CONSENSUS STATEMENT
KW - REDUCED EJECTION FRACTION
KW - NONSUSTAINED VENTRICULAR-TACHYCARDIA
KW - ATRIOVENTRICULAR JUNCTION ABLATION
KW - ANGIOTENSIN-NEPRILYSIN INHIBITION
KW - BUNDLE-BRANCH BLOCK
KW - 2016 ESC GUIDELINES
KW - LONG-TERM OUTCOMES
U2 - 10.1002/ejhf.2046
DO - 10.1002/ejhf.2046
M3 - Editorial
C2 - 33136300
SN - 1388-9842
VL - 22
SP - 2349
EP - 2369
JO - European journal of heart failure
JF - European journal of heart failure
IS - 12
ER -