Cross-sectional study of cardiac resynchronization therapy in Spain. Indications, implant techniques, optimization and follow-up.
OBJECTIVE
A cross-sectional study of cardiac resynchronization therapy use in Spain was performed to analyze problems with indications, implantation, and patient follow-up.


METHODS
Spanish cardiac resynchronization therapy implanter centers were identified, then the department members were surveyed and the data were recorded by each implantation team.


RESULTS
Eighty-eight implanter centers were identified; of these, 85 (96.6%) answered the survey. A total of 2147 device implantations were reported, comprising 85.6% of the overall number of 2518 implantations estimated by the European Confederation of Medical Suppliers Associations for the same period. The reported implantation rate was 46 per million inhabitants versus an estimated implantation rate of 51 per million (European average, 131). Cardiac resynchronization therapy devices accounted for 84% of implantations, and upgrades to previously implanted devices, 16%. The majority of cardiac resynchronization therapy devices were implanted in men (70.7%). The mean age was 68 (12) years, and the mean left ventricular ejection fraction was 26.4% (5%). Most patients (67%) were in New York Heart Association functional class III. The group of patients for whom cardiac resynchronization therapy was indicated according to the latest update of the guidelines was significant: 17.3% among New York Heart Association class II patients and more than 21.6% among patients with atrial fibrillation. In all, electrophysiologists accounted for 73.8% of implanters, followed by surgeons, accounting for 21.4%.


CONCLUSIONS
The latest update of the guidelines is being progressively implemented in Spain, according to data obtained in patients in New York Heart Association class II or with atrial fibrillation. Nevertheless, the number of cardiac resynchronization therapy device implants is still well below the European average.
Unidad de Arritmias, Servicio de Cardiología, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain. antoniomadri@gmail.com
Antonio
A
Hernández-Madrid
Roberto
R
Matía Francés
Concepción
C
Moro
José
J
Zamorano
Luis
L
Almenar
Maria José
MJ
Sancho-Tello de Carranza
Ignacio
I
Fernández Lozano
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000706:statistics & numerical data*; D058409:Cardiac Resynchronization Therapy Devices; D000075202:Contraindications; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010560:Personnel Selection; D019114:Remote Consultation; D013030:Spain; D055815:Young Adult