Second European Society of Cardiology Cardiac Resynchronization Therapy Survey: the Italian cohort.,Journal of Cardiovascular Medicine

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Second European Society of Cardiology Cardiac Resynchronization Therapy Survey: the Italian cohort.
Journal of Cardiovascular Medicine ( IF 3 ) Pub Date : 2020-09-01 , DOI: 10.2459/jcm.0000000000001035
Giovanni L Botto ₁ , Maurizio Gasparini ₂ , Francesco M A Brasca ₁ , Maria C Casale _{1,

2} , Eraldo Occhetta ₃ , Marco Racheli ₄ , Manuel Bertaglia ₅ , Francesco Zanon ₆ , Marco Zardini ₇ , Antonio Rapacciuolo ₈ , Giosuè Mascioli ₉ , Antonio Curnis ₁₀ , Marco Metra ₁₀ , Camilla Normand _{11,

12} , Kenneth Dickstein ₁₂ , Cecilia Linde ₁₃

Affiliation

Cardiology and Electrophysiology Division, ASST Rhodense, Garbagnate M.
Electrophysiology Division, Humanitas Research Hospital IRCCS, Rozzano, Milan.
Electrophysiology Division, AOU Ospedale Maggiore della Carità, Novara.
Cardiology Division, Ospedale St Andrea, La Spezia.
Cardiology Division, AO Padova, Padua.
Cardiology Division, Ospedale Santa Maria della Misericordia, Rovigo.
Cardiology Division, AOU Ospedale Maggiore di Parma, Parma.
Cardiology Division, AOU Federico II, Naples.
Electrophysiology Division, Cliniche Humanitas Gavazzeni, Bergamo.
Cardiology Division, University of Brescia, Spedali Civili, Brescia, Italy.
Institute of Internal Medicine, University of Bergen, Bergen.
Cardiology Division, Stavanger University Hospital, Stavanger, Norway.
Heart and Vascular Theme, Karolinska University Hospital, Stockholm, and Karolinska Institutet, Stockholm, Sweden.

Aim

Adherence to guidelines was not homogeneous in Europe, according to the survey on cardiac resynchronization therapy conducted in 2008–2009. The aim of our study was to compare the results in the Italian and European cohorts of the Second European Cardiac Resynchronization Therapy Survey.

Methods

Patients’ characteristics, procedural data and follow-up were collected. Italian records were compared with European countries.

Results

Italian hospitals enrolled 526 patients. The italian cohort was older (71.6 ± 9.5 vs. 68.4 ± 10.8; P < 0.00001), had less severe NYHA class (>II 47.2 vs. 59.6%; P < 0.00001), higher ejection fraction (30.3 ± 7.4 vs. 28.4 ± 8.2%; P < 0.00001), and less atrial fibrillation prevalence (34.4 vs. 41.2%; P = 0.00197) than the European cohort. Italian patients were more frequently hospitalized for heart failure in the previous year (51.9 vs. 46.2%; P = 0.01118) and had lower mean QRS duration (151 ± 26 vs. 157 ± 27 ms; P < 0.0001). CRT-D were more often implanted in Italian patients (79.3 vs. 69.3%; P < 0.00001). The complication rate was similar (4.6% vs. 5.6%; ns). The rate of use of ACEi/ARBs in Italy was lower than in Europe (77.2 vs. 86.9%; P < 0.00001). Patients were followed up in the implantation centre (92.1 vs. 86%; P = 0.00014), but rarely with remote monitoring (25.9 vs. 30%; P = 0.04792).

Conclusion

The survey demonstrates important similarities as well as substantial differences regarding most of the aspects evaluated. Efforts to implement adherence to guidelines will be endorsed in Italy.

中文翻译：

第二次欧洲心脏病学会心脏再同步治疗调查：意大利队列。

目的

根据 2008 年至 2009 年进行的心脏再同步治疗调查，欧洲对指南的遵守情况并不均匀。我们研究的目的是比较第二次欧洲心脏再同步治疗调查中意大利和欧洲队列的结果。

方法

收集患者的特征、手术数据和随访情况。意大利的记录与欧洲国家进行了比较。

结果

意大利医院招募了 526 名患者。意大利队列年龄较大（71.6 ± 9.5 vs. 68.4 ± 10.8；P < 0.00001），NYHA 分级较轻（>II 47.2 vs. 59.6%；P < 0.00001），射血分数较高（30.3 ± 7.4 vs. 28.4 ± 8.2%；P < 0.00001），并且房颤患病率低于欧洲队列（34.4 vs. 41.2%； P = 0.00197）。意大利患者前一年因心力衰竭住院的比例更高（51.9% vs. 46.2%； P = 0.01118），平均 QRS 时限较低（151 ± 26 vs. 157 ± 27 ms；P < 0.0001）。意大利患者更常植入 CRT-D（79.3% vs. 69.3%；P < 0.00001）。并发症发生率相似（4.6% vs. 5.6%；ns）。意大利 ACEi/ARB 的使用率低于欧洲（77.2% vs. 86.9%；P < 0.00001）。患者在植入中心接受随访（92.1 vs. 86%；P = 0.00014），但很少进行远程监控（25.9 vs. 30%；P = 0.04792）。