title: Do cardiologists follow the European guidelines for cardiac pacing and resynchronization therapy? Results of the European Heart Rhythm Association survey.
abstract: The purpose of this European Heart Rhythm Association (EHRA) EP wire survey was to evaluate the implementation of the current guidelines for cardiac pacing and cardiac resynchronization therapy (CRT) in Europe. A total of 48 centres replied to the survey, 34 of them (71%) were university hospitals. All responding centres implement CRT in patients with classical indications, i.e. sinus rhythm, New York Heart Association (NYHA) functional class II, III, or ambulatory IV, left ventricular ejection fraction (LVEF) 35%, and left bundle-branch block (LBBB) with QRS duration >150 ms, while 31 centres (67%) would implant a CRT device in patients with the same characteristics but with a non-LBBB pattern. Forty-one centres (89%) would also implant CRT in patients with sinus rhythm, NYHA Class II, III, or ambulatory IV, LVEF <35%, and LBBB with QRS duration between 120 and 150 ms, while only eight centres (17%) would implant the device in patients with the same characteristics but with a non-LBBB pattern. In patients with LVEF <35% and QRS duration below 120 ms, the majority of the centres (80%) would implant a single- or dual-chamber implantable cardioverter-defibrillator, but in nine cases (20%) no device was considered to be indicated. The results of this survey showed a good adherence to some of the current recommendations. Still some reluctance exists when offering the device therapy to patients with QRS duration in the lower range.
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala 75185, Sweden elenasciaraffia@mail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Sciaraffia
authors.affiliation: Second Cardiology Department, Attikon University Hospital, University of Athens, Rimini 1, Haidari Athens 12462, Greece.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Dagres
authors.affiliation: Cardiology Department, Ramon y Cajal Hospital, Carretera Colmenar Viejo, km 9, 100, Madrid 28034, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernandez-Madrid
authors.affiliation: Division of Cardiology, Department of Cardiothoracic Science, University Hospital S. Maria Della Misericordia, Udine, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK.
authors.forename: Derick
authors.initials: D
authors.lastname: Todd
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala 75185, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000592:standards* / Q000706:statistics & numerical data*; D058406:Cardiac Resynchronization Therapy / Q000592:standards* / Q000706:statistics & numerical data*; D002309:Cardiology / Q000592:standards; D005060:Europe / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006333:Heart Failure / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D015995:Prevalence
keywords: Adherence; Cardiac pacing; Cardiac resynchronization therapy; EHRA survey; EP wire; ESC guidelines