The European CRT Survey: 1 year (9-15 months) follow-up results
Nigussie Bogale, Silvia Priori, John G F Cleland, Josep Brugada, Cecilia Linde, Angelo Auricchio, Dirk J van Veldhuisen, Tobias Limbourg, Anselm Gitt, Daniel Gras, Christoph Stellbrink, Maurizio Gasparini, Marco Metra, Geneviève Derumeaux, Fredrik Gadler, Laszlo Buga, Kenneth Dickstein, Scientific Committee, National Coordinators, and Investigators, Kenneth Dickstein, Silvia Priori, Angelo Auricchio, Nigussie Bogale, Josep Brugada, John G F Cleland, Geneviève Derumeaux, Anselm Gitt, Daniel Gras, Michel Komajda, Cecilia Linde, John Morgan, Dirk J van Veldhuisen, Friedrich Fruhwald, Bernhard Strohmer, Marc Goethals, Johan Vijgen, Jean Noel Trochu, Daniel Gras, Michael Kindermann, Christoph Stellbrink, Ken McDonnald, David Keane, Tuvia Ben Gal, Michael Glikson, Marco Metra, Maurizio Gasparini, Alexander Maass, Luc Jordaens, Marco Alings, Alf Inge Larsen, Svein Færestrand, Juan Delgado, Lluis Mont, Hans Persson, Fredrik Gadler, Hans Peter Brunner-La Rocca, Stefan Osswald, Ian Squire, John Morgan, Nigussie Bogale, Silvia Priori, John G F Cleland, Josep Brugada, Cecilia Linde, Angelo Auricchio, Dirk J van Veldhuisen, Tobias Limbourg, Anselm Gitt, Daniel Gras, Christoph Stellbrink, Maurizio Gasparini, Marco Metra, Geneviève Derumeaux, Fredrik Gadler, Laszlo Buga, Kenneth Dickstein, Scientific Committee, National Coordinators, and Investigators, Kenneth Dickstein, Silvia Priori, Angelo Auricchio, Nigussie Bogale, Josep Brugada, John G F Cleland, Geneviève Derumeaux, Anselm Gitt, Daniel Gras, Michel Komajda, Cecilia Linde, John Morgan, Dirk J van Veldhuisen, Friedrich Fruhwald, Bernhard Strohmer, Marc Goethals, Johan Vijgen, Jean Noel Trochu, Daniel Gras, Michael Kindermann, Christoph Stellbrink, Ken McDonnald, David Keane, Tuvia Ben Gal, Michael Glikson, Marco Metra, Maurizio Gasparini, Alexander Maass, Luc Jordaens, Marco Alings, Alf Inge Larsen, Svein Færestrand, Juan Delgado, Lluis Mont, Hans Persson, Fredrik Gadler, Hans Peter Brunner-La Rocca, Stefan Osswald, Ian Squire, John Morgan
Abstract
Aims: The European CRT Survey is a joint initiative of the Heart Failure Association (HFA) and the European Heart Rhythm Association (EHRA) of the European Society of Cardiology evaluating the contemporary implantation practice of cardiac resynchronization therapy (CRT) in Europe.
Methods and results: Patients who had a successful CRT implantation were enrolled from 141 centres in 13 countries between November 2008 and June 2009. Baseline demographics, clinical and implantation data were collected, with a follow-up of ∼1 year (9-15 months). The current report describes clinical outcomes including symptom severity, cardiovascular (CV) hospitalization, and survival. A total of 2438 patients were enrolled, and follow-up data were acquired from 2111 patients (87%). The population included important groups of patients poorly represented in randomized controlled trials, including very elderly patients and those with prior device implantation, atrial fibrillation, and/or QRS duration <120 ms. Investigators reported substantial improvement in New York Heart Association (NYHA) functional class at follow-up. Patient self-assessment indicated that 81% of the patients felt improved, 16% reported no change, and 4% reported deterioration. During follow-up, 207 (10%) patients died, 346 (16%) had a CV hospitalization, and 501 (24%) died or had CV hospitalization. Worse NYHA functional class, atrial fibrillation, ischaemic aetiology, and device type (CRT-P, i.e. CRT alone) were associated with poorer survival. Women had a better outcome, as did patients who had a CRT-D (with an implantable cardioverter defibrillator function) device.
Conclusions: Outcomes including death and hospitalization in this European CRT survey were consistent with results from clinical trials of CRT. At 1 year follow-up, most patients who received a CRT device considered their symptoms improved compared with their pre-implant assessment. Although prospective, this is an observational study of successful CRT implantations, and outcomes in subgroup analyses must be interpreted with appropriate conservatism.
Trial registration: ClinicalTrials.gov NCT01185392.
Source: PubMed