Beaumont Hospital Dublin, Dublin, Ireland.
Mater Misericordiae University Hospital, Dublin, Ireland.
Ir J Med Sci. 2020 Aug;189(3):895-905. doi: 10.1007/s11845-020-02173-y. Epub 2020 Jan 24.
Cardiac resynchronization therapy (CRT) has been shown to reduce mortality and morbidity in symptomatic patients with reduced left ventricular systolic function < 35%, a left bundle branch block (LBBB) and a widened QRS complex. This paper compares Irish national CRT practices with the European data that was gathered in the same multi-centre CRT Survey II.
Each recruiting centre completed an internet-based facilitating collection of information relating to health care resource utilization by each centre. A second form was completed for consecutive patients undergoing CRT implantation, to provide information on patient demographics, pre-implantation clinical evaluation and investigations, indication for implantation and the procedure as well as short-term complications and adverse events.
A total of 85 patients from 2 centres were representative of the current Irish practice and compared with data obtained. This was 26.6% of all CRT implantations in Ireland during this period (total number 319, 88 CRT-P, 231 CRT-D). Of those receiving CRT device, mean age was 73 years, 74.1% were male, with predominantly NYHA class III symptoms, and left ventricular ejection fraction < 35%. NT-pro-BNP level was substantially elevated in most patients. 56% were in sinus rhythm, 31% in atrial fibrillation with overall mean QRS duration of 166 ms.
Within Ireland, the majority of CRT implantation are adherent with ESC guidelines. It has also highlighted problems that are noted in other ESC member countries such as the underutilization of device therapy in women, lack of referrals from peripheral centres and further need for optimization of medical therapy before device implantation.
心脏再同步治疗（CRT）已被证明可降低左心室收缩功能<35%、左束支传导阻滞（LBBB）和宽 QRS 复合物的有症状患者的死亡率和发病率。本文比较了爱尔兰国家 CRT 实践与在同一多中心 CRT 调查 II 中收集的欧洲数据。
每个招募中心都通过互联网完成了一项信息收集，涉及每个中心的医疗保健资源利用情况。第二份表格用于连续接受 CRT 植入的患者，提供患者人口统计学、植入前临床评估和检查、植入指征以及程序以及短期并发症和不良事件的信息。
来自 2 个中心的 85 名患者代表了当前的爱尔兰实践，并与获得的数据进行了比较。这占爱尔兰在此期间所有 CRT 植入的 26.6%（总数 319 例，88 例 CRT-P，231 例 CRT-D）。在接受 CRT 设备的患者中，平均年龄为 73 岁，74.1%为男性，主要有 NYHA Ⅲ级症状，左心室射血分数<35%。大多数患者的 NT-pro-BNP 水平显著升高。56%为窦性心律，31%为心房颤动，总平均 QRS 持续时间为 166ms。
在爱尔兰，大多数 CRT 植入符合 ESC 指南。它还突出了 ESC 成员国中存在的问题，例如女性设备治疗的利用率低、来自周边中心的转诊不足以及在设备植入前进一步需要优化药物治疗。
