title: Approach to cardiac resyncronization therapy.
abstract: OBJECTIVE
  The purpose of this EP Wire is to compare indications, techniques, implant strategy, and follow-up regarding cardiac resynchronization therapy (CRT) in several countries across Europe.
  
  
  RESULTS
  Forty-one centres, members of the EHRA-EP Research Network, responded to this survey and completed the questions. Thirty-two per cent of the responding centres always use CRT in heart failure (HF) patients with New York Heart Association functional class II and QRS width >120 ms, and 55% of the responding centres demand additional criteria when indicating CRT, most often QRS width >150 ms (49%) and echocardiographic criteria of asynchrony (34%). Only 10% of centres indicate CRT in all HF patients with QRS >120 ms and right bundle branch block, and 51% demand additional criteria, most frequently echocardiographic asynchrony parameters. The vast majority of centres also indicate CRT in patients with atrial fibrillation and standard criteria for CRT. In 24% of the centres, biventricular pacemaker (CRT-P) is implanted in all situations, unless there is an indication for secondary prevention of sudden cardiac death, while 10% always choose to implant a biventricular defibrillator (CRT-D). There are no clear evidence-based recommendations concerning the implant procedure and follow-up in patients treated with CRT; therefore, the chosen strategies vary widely from one centre to another.
  
  
  CONCLUSIONS
  This EP Wire survey shows a wide variation not only as far as CRT indications are concerned, but especially in techniques, implant strategy, and follow-up across the European countries.
authors.affiliation: University of Medicine and Pharmacy & Cardiovascular Disease and Transplant Institute, Târgu Mureş, Romania. dobreanu@yahoo.com
authors.forename: Dan
authors.initials: D
authors.lastname: Dobreanu
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Dagres
authors.forename: Jesper Hastrup
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Germanas
authors.initials: G
authors.lastname: Marinskis
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Bongiorni
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
mesh_terms: D001281:Atrial Fibrillation / Q000628:therapy; D002037:Bundle-Branch Block / Q000628:therapy; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D058409:Cardiac Resynchronization Therapy Devices / Q000706:statistics & numerical data; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004452:Echocardiography / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D005060:Europe; D019538:Health Care Surveys; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D016896:Treatment Outcome