Second European Society of Cardiology Cardiac Resynchronization Therapy Survey: the Italian cohort

Aim Adherence to guidelines was not homogeneous in Europe, according to the survey on cardiac resynchronization therapy conducted in 2008-2009. The aim of our study was to compare the results in the Italian and European cohorts of the Second European Cardiac Resynchronization Therapy Survey. Methods Patients' characteristics, procedural data and follow-up were collected. Italian records were compared with European countries. Results Italian hospitals enrolled 526 patients. The italian cohort was older (71.6 +/- 9.5 vs. 68.4 +/- 10.8;P < 0.00001), had less severe NYHA class (>II 47.2 vs. 59.6%;P < 0.00001), higher ejection fraction (30.3 +/- 7.4 vs. 28.4 +/- 8.2%;P < 0.00001), and less atrial fibrillation prevalence (34.4 vs. 41.2%;P = 0.00197) than the European cohort. Italian patients were more frequently hospitalized for heart failure in the previous year (51.9 vs. 46.2%;P = 0.01118) and had lower mean QRS duration (151 +/- 26 vs. 157 +/- 27 ms;P < 0.0001). CRT-D were more often implanted in Italian patients (79.3 vs. 69.3%;P < 0.00001). The complication rate was similar (4.6% vs. 5.6%; ns). The rate of use of ACEi/ARBs in Italy was lower than in Europe (77.2 vs. 86.9%;P < 0.00001). Patients were followed up in the implantation centre (92.1 vs. 86%;P = 0.00014), but rarely with remote monitoring (25.9 vs. 30%;P = 0.04792). Conclusion The survey demonstrates important similarities as well as substantial differences regarding most of the aspects evaluated. Efforts to implement adherence to guidelines will be endorsed in Italy.