Department of Cardiology, Faculty of Medicine, Hacettepe University; Ankara-Turkey.
Department of Cardiology, Medical Park Göztepe Hospital; İstanbul-Turkey.
Anatol J Cardiol. 2020 Dec;24(6):382-396. doi: 10.14744/AnatolJCardiol.2020.02680.
Cardiac resynchronization therapy (CRT) has been shown to reduce mortality in selected patients with heart failure with reduced ejection fraction (HFrEF). CRT Survey-II was a snapshot survey to assess current clinical practice with regard to CRT. Herein, we aimed to compare Turkish data with other countries of European Society of Cardiology (ESC).
The survey was conducted between October 2015 and December 2016 in 42 ESC member countries. All consecutive patients who underwent a de novo CRT implantation or a CRT upgrade were eligible.
A total of 288 centers included 11,088 patients. From Turkey, 16 centers recruited 424 patients representing 12.9% of all implantations. Compared to the entire cohort, Turkish patients were younger with a lower proportion of men and a higher proportion with ischemic etiology. Electrocardiography (ECG) showed sinus rhythm in 81.5%, a QRS duration of <130 ms in 10.1%, and ≥150 ms in 63.8% of patients. Left bundle branch block (LBBB) was more common. Median left ventricular ejection fraction (LVEF) was 25%, lower than in the overall ESC cohort, but NYHA class was more often II. Most common indication for CRT implantation was HF with a wide QRS (70.8%). Almost 98.3% of devices implanted were CRT-D, in contrast to the overall cohort. Fluoroscopy time was longer, but duration of overall procedure was shorter. LV lead implantation was unsuccessful in 2.6% patients. Periprocedural complication rate was 6.3%. The most common complication was bleeding. Remote monitoring was less utilized.
These are the first observational data reflecting the current CRT practice in Turkey and comparing it with other countries of Europe. Findings of this study may help detect gaps and provide insights for improvement.
心脏再同步治疗（CRT）已被证明可降低射血分数降低的心力衰竭（HFrEF）患者的死亡率。CRT Survey-II 是一项快照调查，旨在评估 CRT 目前的临床实践。在此，我们旨在将土耳其数据与欧洲心脏病学会（ESC）的其他国家进行比较。
该调查于 2015 年 10 月至 2016 年 12 月在 42 个 ESC 成员国进行。所有接受新 CRT 植入或 CRT 升级的连续患者均符合条件。
共有 288 个中心纳入了 11088 名患者。来自土耳其的 16 个中心招募了 424 名患者，占所有植入患者的 12.9%。与整个队列相比，土耳其患者年龄较小，男性比例较低，缺血性病因比例较高。心电图（ECG）显示窦性心律占 81.5%，QRS 持续时间<130ms 占 10.1%，≥150ms 占 63.8%的患者。左束支传导阻滞（LBBB）更为常见。中位左心室射血分数（LVEF）为 25%，低于 ESC 总体队列，但 NYHA 分级更为常见。CRT 植入的最常见适应证是宽 QRS 的心力衰竭（70.8%）。植入的设备几乎 98.3%为 CRT-D，与总体队列形成对比。透视时间较长，但总手术时间较短。LV 导联植入不成功的患者占 2.6%。围手术期并发症发生率为 6.3%。最常见的并发症是出血。远程监测利用较少。
这些是反映土耳其当前 CRT 实践并与欧洲其他国家进行比较的首批观察性数据。本研究的结果可能有助于发现差距并提供改进的见解。
