Optimized implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

W. Mullens*, A. Auricchio, P. Martens, K. Witte, M.R. Cowie, V. Delgado, K. Dickstein, C. Linde, K. Vernooy, F. Leyva, J. Bauersachs, C.W. Israel, L.H. Lund, E. Donal, G. Boriani, T. Jaarsma, A. Berruezo, V. Traykov, Z. Yousef, Z. KalarusJ.C. Nielsen, J. Steffel, P. Vardas, A. Coats, P. Seferovic, T. Edvardsen, H. Heidbuchel, F. Ruschitzka, C. Leclercq, European Society of Cardiology

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

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 languageEnglish
Pages (from-to)1324-1342
Number of pages19
JournalEP Europace
Volume23
Issue number8
DOIs
Publication statusPublished - 1 Aug 2021

Keywords

  • Cardiac resynchronization therapy
  • Response
  • Heart failure
  • Implementation
  • Utilization
  • Care pathways
  • Disease modification
  • Disease management
  • Outcome
  • HEART-FAILURE PATIENTS
  • IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
  • PERMANENT ATRIAL-FIBRILLATION
  • EXPERT CONSENSUS STATEMENT
  • REDUCED EJECTION FRACTION
  • NONSUSTAINED VENTRICULAR-TACHYCARDIA
  • ATRIOVENTRICULAR JUNCTION ABLATION
  • ANGIOTENSIN-NEPRILYSIN INHIBITION
  • BUNDLE-BRANCH BLOCK
  • LONG-TERM OUTCOMES

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