Optimized implementation of cardiac resynchronization therapy: 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. (8th February 2021)

• Record Type: Journal Article
• Authors: Mullens, Wilfried; Auricchio, Angelo; Martens, Pieter; Witte, Klaus; Cowie, Martin R.; Delgado, Victoria; Dickstein, Kenneth; Linde, Cecilia; Vernooy, Kevin; Leyva, Francisco; Bauersachs, Johann; Israel, Carsten W.; Lund, Lars H.; Donal, Erwan; Boriani, Giuseppe; Jaarsma, Tiny; Berruezo, Antonio; Traykov, Vassil; Yousef, Zaheer; Kalarus, Zbigniew; Cosedis Nielsen, Jens; Steffel, Jan; Vardas, Panos; Coats, Andrew; Seferovic, Petar; Edvardsen, Thor; Heidbuchel, Hein; Ruschitzka, Frank; Leclercq, Christophe
• Is Part Of: European journal of heart failure. Volume 22:Number 12(2020)
• Page Start: 2349
• Page End: 2369
• Publication Date: 2021-02-08
• Subjects: Cardiac resynchronization therapy -- Response -- Heart failure -- Implementation -- Utilization -- Care pathways -- Disease modification -- Disease management -- Outcome; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.2046
• Languages: English
• ISSNs: 1388-9842

Abstract

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. Abstract :