Why the study?
Up to two-thirds of eligible heart failure with reduced ejection fraction patients are not referred for CRT, and post-implantation follow-up is often fragmented and suboptimal.
This joint European position statement provides actionable strategies to overcome the under-utilization of CRT and optimize post-implantation care for patients with HFrEF.
Adoption of these strategies may increase appropriate CRT use in HFrEF; extends ESC consensus with four practical domains for referral and follow-up.
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 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 European Society of Cardiology Associations, Heart Failure Association (HFA), European Heart Rhythm Association (EHRA) and European Association of Cardiovascular Imaging (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.
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Müllens et al. (2020) conducted a review in Heart failure with reduced ejection fraction. Cardiac resynchronization therapy (CRT) was evaluated. A joint position statement from European Society of Cardiology associations provides theoretical and practical strategies to improve CRT referral and post-procedural care across four actionable domains.
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