Brusich Sandro, Zeljković Ivan, Pavlovic Nikola, Anić Ante, Jurišić Zrinka, Židan David, Klasan Marina, Čubranić Zlatko, Dickstein Kenneth, Linde Cecilia, Normand Camilla, Manola Sime
Rijeka University Hospital Centre, Rijeka, Croatia.
Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia.
Cardiol Res Pract. 2018 Oct 25;2018:3479846. doi: 10.1155/2018/3479846. eCollection 2018.
The Cardiac Resynchronization Therapy (CRT) Survey II was conducted between October 2015 and December 2016 and included data from 11088 CRT implantations from 42 countries. The survey's aim was to report on current European CRT practice. The aim of this study was to compare the Croatian national CRT practice with the European data.
Five centres from Croatia recruited consecutive patients, in a 15-month period, who underwent CRT implantation, primary or an upgrade. Data were collected prospectively by using online database.
A total of 115 patients were included in Croatia, which is 33.2% of all CRT implants in Croatia during the study period (total =346). Median age of the study population was 67 (61-73) years, and 21.2% were women. Primary heart failure (HF) aetiology was nonischemic in 61.1% of patients, and HF with wide QRS was the most common indication for the implantation (73.5%). 80% of patients had complete left bundle branch block, and over two-third had QRS ≥150 ms. Device-related adverse events were recorded in 4.3% of patients. When compared with European countries, Croatian patients were significantly younger (67 vs. 70 years, =0.012), had similar rate of comorbidities with the exception of higher prevalence of hypertension. Croatian patients significantly more often received CRT-pacemaker when compared with European population (58.3 vs. 29.9%, OR 3.27, 95%CI 2.25-4.74, < 0.001).
Our data indicate strict selection of patients among HF population and adherence to guidelines with exception of higher proportion of CRT-pacemaker implantation. This is likely to be influenced by healthcare organization and reimbursement issues in Croatia.
心脏再同步治疗（CRT）调查II于2015年10月至2016年12月期间开展，纳入了来自42个国家的11088例CRT植入数据。该调查旨在报告当前欧洲CRT的应用情况。本研究的目的是将克罗地亚全国的CRT应用情况与欧洲数据进行比较。
克罗地亚的5个中心在15个月的时间里连续招募了接受CRT植入（初次植入或升级植入）的患者。通过在线数据库前瞻性收集数据。
克罗地亚共纳入了115例患者，占研究期间克罗地亚所有CRT植入病例的33.2%（总数=346）。研究人群的中位年龄为67（61-73）岁，女性占21.2%。61.1%的患者原发性心力衰竭（HF）病因是非缺血性的，宽QRS波的HF是最常见的植入指征（73.5%）。80%的患者有完全性左束支传导阻滞，超过三分之二的患者QRS≥150毫秒。4.3%的患者记录到与设备相关的不良事件。与欧洲国家相比，克罗地亚患者明显更年轻（67岁对70岁，P=0.012），除高血压患病率较高外，合并症发生率相似。与欧洲人群相比，克罗地亚患者接受CRT起搏器的比例明显更高（58.3%对29.9%，OR 3.27，95%CI 2.25-4.74，P<0.001）。
我们的数据表明在HF人群中对患者进行了严格筛选并遵循了指南，但CRT起搏器植入比例较高除外。这可能受到克罗地亚医疗组织和报销问题的影响。
