Optimized Implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

Wilfried Mullens; Angelo Auricchio; Pieter Martens; Klaus Witte; Martin R Cowie; Victoria Delgado; Kenneth Dickstein; Cecilia Linde; Kevin Vernooy; Francisco Leyva; Johann Bauersachs; Carsten W Israel; Lars Lund; Erwan Donal; Giuseppe Boriani; Tiny Jaarsma; Antonio Berruezo; Vassil Traykov; Zaheer Yousef; Zbigniew Kalarus; Jens Cosedis Nielsen; Jan Steffel; Panos Vardas; Andrew Coats; Petar Seferovic; Thor Edvardsen; Hein Heidbuchel; Frank Ruschitzka; Christophe Leclercq

doi:10.1002/ejhf.2046

Optimized Implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

Wilfried Mullens
, Angelo Auricchio
, Pieter Martens
, Klaus Witte
, Martin R Cowie
, Victoria Delgado
, Kenneth Dickstein
, Cecilia Linde
, Kevin Vernooy
, Francisco Leyva
, Johann Bauersachs
, Carsten W Israel
, Lars Lund
, Erwan Donal
, Giuseppe Boriani
, Tiny Jaarsma
, Antonio Berruezo
, Vassil Traykov
, Zaheer Yousef
, Zbigniew Kalarus

Jens Cosedis Nielsen, Jan Steffel, Panos Vardas, Andrew Coats, Petar Seferovic, Thor Edvardsen, Hein Heidbuchel, Frank Ruschitzka, Christophe Leclercq

Ziekenhuis Oost Limburg, Genk University Hasselt Hasselt both in Belgium
Division of Cardiology Cardiocentro Ticino Lugano Switzerland
Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds UK
Imperial College London (Royal Brompton Hospital) London United Kingdom
Department of Cardiology Leiden University Medical Center Leiden The Netherlands
University of Bergen, Stavanger University Hospital Norway
Heart and Vascular Theme Karolinska University Hospital and Karolinska Institutet Stockholm Sweden
Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, and Department of Cardiology Radboud University Medical Center (Radboudumc) Nijmegen both in the Netherlands
Department of Cardiology and Angiology Hannover Medical School Hannover Germany
Department of Medicine – Cardiology, Diabetology and Nephrology Bethel‐Clinic Bielefeld Germany
Department of Medicine Karolinska Institutet, and Department of Cardiology Karolinska University Hospital
Cardiologie – CHU Rennes – LTSI Inserm UMR 1099 ‐ Université Rennes‐1 Rennes France
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy
Julius Center, University Medical Center Utrecht, the Netherlands and Department of Health, Medicine and Caring Science Linköping University Sweden
Heart Institute, Teknon Medical Center Barcelona Spain
Department of Cardiology Acibadem City Clinic Tokuda Hospital Sofia Bulgaria
Department of Cardiology University Hospital of Wales & Cardiff University
Katowice, Poland Department of Cardiology Medical University of Silesia
Department of Cardiology Aarhus University Hospital Aarhus Denmark
UniversitätsSpital Zürich Zürich Switzerland
Heart Sector, Hygeia Hospitals Group Athens Greece
Istituto di Scienze e Tecnologie della Cognizione
Faculty of Medicine, Serbian Academy of Science and Arts Belgrade University Belgrade Serbia
Dept of Cardiology Oslo University Hospital, Rikshospitalet, and University of Oslo Oslo Norway
Antwerp University and Antwerp University Hospital Antwerp Belgium

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Abstract

Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and reduces all‐cause mortality. Nevertheless, up to two‐thirds of eligible patients are not referred for CRT. Furthermore, post implantation follow‐up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three ESC Associations, HFA, EHRA and EACVI focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post‐procedural care by focusing on four actionable domains; (I) overcoming CRT under‐utilization, (II) better understanding of pre‐implant characteristics, (III) abandoning the term ‘non‐response’ and replacing this by the concept of disease modification, and (IV) implementing a dedicated post‐implant CRT care pathway.

Original language	English
Pages (from-to)	2349-2369
Number of pages	21
Journal	European Journal of Heart Failure
Volume	22
Issue number	12
Early online date	2 Nov 2020
DOIs	https://doi.org/10.1002/ejhf.2046
Publication status	Published - Dec 2020

Bibliographical note

This is the peer reviewed version of the following article: Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M.R., Delgado, V., Dickstein, K., Linde, C., Vernooy, K., Leyva, F., Bauersachs, J., Israel, C.W., Lund, L., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., Kalarus, Z., Nielsen, J.C., Steffel, J., Vardas, P., Coats, A., Seferovic, P., Edvardsen, T., Heidbuchel, H., Ruschitzka, F. and Leclercq, C. (2020), Optimized Implementation of cardiac resynchronization therapy – a call for action for referral and optimization of care. Eur J Heart Fail. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1002/ejhf.2046. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

Keywords

Cardiology and Cardiovascular Medicine

Access to Document

10.1002/ejhf.2046

Optimized Implementation of cardiac resynchronization therapy
This is the peer reviewed version of the following article: Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M.R., Delgado, V., Dickstein, K., Linde, C., Vernooy, K., Leyva, F., Bauersachs, J., Israel, C.W., Lund, L., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., Kalarus, Z., Nielsen, J.C., Steffel, J., Vardas, P., Coats, A., Seferovic, P., Edvardsen, T., Heidbuchel, H., Ruschitzka, F. and Leclercq, C. (2020), Optimized Implementation of cardiac resynchronization therapy – a call for action for referral and optimization of care. Eur J Heart Fail. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1002/ejhf.2046. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Accepted author manuscript, 2.32 MB

Cite this

Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M. R., Delgado, V., Dickstein, K., Linde, C., Vernooy, K., Leyva, F., Bauersachs, J., Israel, C. W., Lund, L., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., ... Leclercq, C. (2020). Optimized Implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care. European Journal of Heart Failure, 22(12), 2349-2369. https://doi.org/10.1002/ejhf.2046

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abstract = "Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and reduces all‐cause mortality. Nevertheless, up to two‐thirds of eligible patients are not referred for CRT. Furthermore, post implantation follow‐up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three ESC Associations, HFA, EHRA and EACVI focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post‐procedural care by focusing on four actionable domains; (I) overcoming CRT under‐utilization, (II) better understanding of pre‐implant characteristics, (III) abandoning the term {\textquoteleft}non‐response{\textquoteright} and replacing this by the concept of disease modification, and (IV) implementing a dedicated post‐implant CRT care pathway.",

keywords = "Cardiology and Cardiovascular Medicine",

author = "Wilfried Mullens and Angelo Auricchio and Pieter Martens and Klaus Witte and Cowie, \{Martin R\} and Victoria Delgado and Kenneth Dickstein and Cecilia Linde and Kevin Vernooy and Francisco Leyva and Johann Bauersachs and Israel, \{Carsten W\} and Lars Lund and Erwan Donal and Giuseppe Boriani and Tiny Jaarsma and Antonio Berruezo and Vassil Traykov and Zaheer Yousef and Zbigniew Kalarus and Nielsen, \{Jens Cosedis\} and Jan Steffel and Panos Vardas and Andrew Coats and Petar Seferovic and Thor Edvardsen and Hein Heidbuchel and Frank Ruschitzka and Christophe Leclercq",

note = "This is the peer reviewed version of the following article: Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M.R., Delgado, V., Dickstein, K., Linde, C., Vernooy, K., Leyva, F., Bauersachs, J., Israel, C.W., Lund, L., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., Kalarus, Z., Nielsen, J.C., Steffel, J., Vardas, P., Coats, A., Seferovic, P., Edvardsen, T., Heidbuchel, H., Ruschitzka, F. and Leclercq, C. (2020), Optimized Implementation of cardiac resynchronization therapy – a call for action for referral and optimization of care. Eur J Heart Fail. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1002/ejhf.2046. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.",

year = "2020",

month = dec,

doi = "10.1002/ejhf.2046",

language = "English",

volume = "22",

pages = "2349--2369",

journal = "European Journal of Heart Failure",

issn = "1388-9842",

publisher = "Oxford University Press",

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Mullens, W, Auricchio, A, Martens, P, Witte, K, Cowie, MR, Delgado, V, Dickstein, K, Linde, C, Vernooy, K, Leyva, F, Bauersachs, J, Israel, CW, Lund, L, Donal, E, Boriani, G, Jaarsma, T, Berruezo, A, Traykov, V, Yousef, Z, Kalarus, Z, Nielsen, JC, Steffel, J, Vardas, P, Coats, A, Seferovic, P, Edvardsen, T, Heidbuchel, H, Ruschitzka, F & Leclercq, C 2020, 'Optimized Implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care', European Journal of Heart Failure, vol. 22, no. 12, pp. 2349-2369. https://doi.org/10.1002/ejhf.2046

TY - JOUR

T1 - Optimized Implementation of cardiac resynchronization therapy

T2 - a call for action for referral and optimization of care

AU - Mullens, Wilfried

AU - Auricchio, Angelo

AU - Martens, Pieter

AU - Witte, Klaus

AU - Cowie, Martin R

AU - Delgado, Victoria

AU - Dickstein, Kenneth

AU - Linde, Cecilia

AU - Vernooy, Kevin

AU - Leyva, Francisco

AU - Bauersachs, Johann

AU - Israel, Carsten W

AU - Lund, Lars

AU - Donal, Erwan

AU - Boriani, Giuseppe

AU - Jaarsma, Tiny

AU - Berruezo, Antonio

AU - Traykov, Vassil

AU - Yousef, Zaheer

AU - Kalarus, Zbigniew

AU - Nielsen, Jens Cosedis

AU - Steffel, Jan

AU - Vardas, Panos

AU - Coats, Andrew

AU - Seferovic, Petar

AU - Edvardsen, Thor

AU - Heidbuchel, Hein

AU - Ruschitzka, Frank

AU - Leclercq, Christophe

N1 - This is the peer reviewed version of the following article: Mullens, W., Auricchio, A., Martens, P., Witte, K., Cowie, M.R., Delgado, V., Dickstein, K., Linde, C., Vernooy, K., Leyva, F., Bauersachs, J., Israel, C.W., Lund, L., Donal, E., Boriani, G., Jaarsma, T., Berruezo, A., Traykov, V., Yousef, Z., Kalarus, Z., Nielsen, J.C., Steffel, J., Vardas, P., Coats, A., Seferovic, P., Edvardsen, T., Heidbuchel, H., Ruschitzka, F. and Leclercq, C. (2020), Optimized Implementation of cardiac resynchronization therapy – a call for action for referral and optimization of care. Eur J Heart Fail. Accepted Author Manuscript., which has been published in final form at https://doi.org/10.1002/ejhf.2046. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

PY - 2020/12

Y1 - 2020/12

N2 - Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and reduces all‐cause mortality. Nevertheless, up to two‐thirds of eligible patients are not referred for CRT. Furthermore, post implantation follow‐up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three ESC Associations, HFA, EHRA and EACVI focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post‐procedural care by focusing on four actionable domains; (I) overcoming CRT under‐utilization, (II) better understanding of pre‐implant characteristics, (III) abandoning the term ‘non‐response’ and replacing this by the concept of disease modification, and (IV) implementing a dedicated post‐implant CRT care pathway.

AB - Cardiac resynchronization therapy (CRT) is one of the most effective therapies for heart failure with reduced ejection fraction and leads to improved quality of life, reductions in heart failure hospitalization rates and reduces all‐cause mortality. Nevertheless, up to two‐thirds of eligible patients are not referred for CRT. Furthermore, post implantation follow‐up is often fragmented and suboptimal, hampering the potential maximal treatment effect. This joint position statement from three ESC Associations, HFA, EHRA and EACVI focuses on optimized implementation of CRT. We offer theoretical and practical strategies to achieve more comprehensive CRT referral and post‐procedural care by focusing on four actionable domains; (I) overcoming CRT under‐utilization, (II) better understanding of pre‐implant characteristics, (III) abandoning the term ‘non‐response’ and replacing this by the concept of disease modification, and (IV) implementing a dedicated post‐implant CRT care pathway.

KW - Cardiology and Cardiovascular Medicine

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DO - 10.1002/ejhf.2046

M3 - Article

SN - 1388-9842

VL - 22

SP - 2349

EP - 2369

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

IS - 12

ER -

Optimized Implementation of cardiac resynchronization therapy: a call for action for referral and optimization of care

Abstract

Bibliographical note

Keywords

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