Ziekenhuis Oost Limburg, Genk, Belgium.
University Hasselt, Hasselt, Belgium.
Europace. 2021 Aug 6;23(8):1324-1342. doi: 10.1093/europace/euaa411.
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.
心脏再同步治疗（CRT）是射血分数降低心力衰竭的最有效治疗方法之一，可提高生活质量，降低心力衰竭住院率和全因死亡率。然而，多达三分之二符合条件的患者未被转介进行 CRT。此外，植入后的随访通常是零散的，并不理想，这阻碍了潜在的最大治疗效果。欧洲心脏病学会协会（HFA）、欧洲心律协会（EHRA）和欧洲心血管成像协会（EACVI）三个欧洲心脏病学会协会的联合立场声明侧重于 CRT 的优化实施。我们提供了理论和实践策略，通过关注四个可操作的领域来实现更全面的 CRT 转介和术后护理：（i）克服 CRT 利用率不足，（ii）更好地了解植入前的特征，（iii）摒弃“无反应”一词，代之以疾病修正的概念，以及（iv）实施专门的植入后 CRT 护理途径。
