Selection of candidates for cardiac resynchronization therapy and implantation management: an Italian survey promoted by the Italian Association of Arrhythmology and Cardiac Pacing.

Autor:	Ziacchi M; Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Dipartimento Cardio-toraco-vascolare, Bologna., Anselmino M; Cardiology Division, 'Città della Salute e della Scienza di Torino' Hospital, Department of Medical Sciences, University of Turin, Turin., Palmisano P; Cardiology Unit, 'Card. G. Panico' Hospital, Tricase., Casella M; Cardiology and Arrhythmology Clinic, University Hospital 'Azienda Ospedaliero-Universitaria delle Marche'.; Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona., Pelargonio G; Institute of Cardiology, Catholic University of Sacred Heart.; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome., Russo V; Cardiology and Syncope Unit, Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli., D'Onofrio A; Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples., Massaro G; Institute of Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Policlinico S.Orsola-Malpighi, Bologna., Vilotta M; Department of Medicine and Surgery, University of Insubria.; Cardiology Unit, Ospedale di Circolo, ASST Settelaghi, Varese., Lauretti M; UOSVD Elettrofisiologia, Ospedale Vito Fazzi, Lecce., Themistoclakis S; Cardiology Division, Ospedale dell'Angelo, Mestre (VE)., Boriani G; Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy., De Ponti R; Department of Medicine and Surgery, University of Insubria.; Cardiology Unit, Ospedale di Circolo, ASST Settelaghi, Varese.
Jazyk:	angličtina
Zdroj:	Journal of cardiovascular medicine (Hagerstown, Md.) [J Cardiovasc Med (Hagerstown)] 2024 Aug 01; Vol. 25 (8), pp. 601-608. Date of Electronic Publication: 2024 Jun 26.
DOI:	10.2459/JCM.0000000000001650
Abstrakt:	Background: Cardiac resynchronization therapy (CRT) represents an effective heart failure treatment, associated with reduction in mortality and heart failure hospitalizations. This Italian survey aimed to address relevant CRT issues. Methods: An online survey was administered to AIAC members. Results: One hundred and five electrophysiologists participated, with a median of 40 (23-70) CRT implantations/year (33% in high-volume centres). Forty-five percent of respondents (especially working in high-volume centres) reported an increase in CRT implantations in the last 2 years, in 16% a decrease, and in 38% CRT remained stable. Seventy-five percent of respondents implanted CRT only in patients with European Heart Rhythm Association (EHRA) class I indications. All operators collected ECG and echocardiography before implantation. Eighty-five percent of respondents selected coronary sinus target vein empirically, whereas 10% used mechanical and/or electrical delay techniques. Physicians working in high-volume centres reported a lower failure rate compared with others (16 vs. 34%; P = 0.03). If the coronary sinus lead could not be positioned in the target branch, 80% placed it in another vein, whereas 16% opted for a surgical approach or for conduction system pacing (CSP). Eighty percent accomplished CRT optimization in all patients, 17% only in nonresponders. Regarding anticoagulation, high agreement with EHRA guidelines emerged. Conclusion: CRT represents a valid therapeutic option in heart failure treatment. Nowadays, CRT implantations remain stable and are mainly performed in patients with class I indications. ECG remains the preferred tool for patient selection, whereas imaging is increasingly used to determine the left pacing target area. In most patients, the left ventricular lead can be successfully positioned in the target vein, but in some cases, the result can be unsatisfactory; however, the decision to explore alternative resynchronization approaches is rarely pursued. (Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)
Databáze:	MEDLINE
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