Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II

Objective: Cardiac resynchronization therapy (CRT) has been shown to reduce mortality in selected patients with heart failure with reduced ejection fraction (HFrEF). CRT Survey-II was a snapshot survey to assess current clinical practice with regard to CRT. Herein, we aimed to com-pare Turkish data with other countries of European Society of Cardiology (ESC).Methods: The survey was conducted between October 2015 and December 2016 in 42 ESC member countries. All consecutive patients who underwent a de novo CRT implantation or a CRT upgrade were eligible.Results: A total of 288 centers included 11,088 patients. From Turkey, 16 centers recruited 424 patients representing 12.9% of all implanta-tions. Compared to the entire cohort, Turkish patients were younger with a lower proportion of men and a higher proportion with ischemic etiology. Electrocardiography (ECG) showed sinus rhythm in 81.5%, a QRS duration of <130 ms in 10.1%, and ≥150 ms in 63.8% of patients. Left bundle branch block (LBBB) was more common. Median left ventricular ejection fraction (LVEF) was 25%, lower than in the overall ESC cohort, but NYHA class was more often II. Most common indication for CRT implantation was HF with a wide QRS (70.8%). Almost 98.3% of devices implanted were CRT-D, in contrast to the overall cohort. Fluoroscopy time was longer, but duration of overall procedure was shorter. LV lead implantation was unsuccessful in 2.6% patients. Periprocedural complication rate was 6.3%. The most common complication was bleeding. Remote monitoring was less utilized.Conclusion: These are the first observational data reflecting the current CRT practice in Turkey and comparing it with other countries of Europe. Findings of this study may help detect gaps and provide insights for improvement. (Anatol J Cardiol 2020; 24: 382-96)

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, et al. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J 2013; 34: 2281-329.
2. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al.; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37: 2129-200.
3. Prinzen FW, Augustijn CH, Arts T, Allessie MA, Reneman RS. Redistribution of myocardial fiber strain and blood flow by asynchronous activation. Am J Physiol 1990; 259: H300-8.
4. Cazeau S, Ritter P, Bakdach S, Lazarus A, Limousin M, Henao L, et al. Four chamber pacing in dilated cardiomyopathy. Pacing Clin Electrophysiol 1994; 17: 1974-9.
5. Lindenfeld J, Feldman AM, Saxon L, Boehmer J, Carson P, Ghali JK, et al. Effects of cardiac resynchronization therapy with or without a defibrillator on survival and hospitalizations in patients with New York Heart Association class IV heart failure. Circulation 2007; 115: 204-12.
6. Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. New Engl J Med 2005; 352: 1539-49.
7. Değertekin M, Erol C, Ergene O, Tokgözoğlu L, Aksoy M, Erol MK, et al. Heart failure prevalence and predictors in Turkey: HAPPY study. Turk Kardiyol Dern Ars 2012; 40: 298-308.
8. Yılmaz MB, Çelik A, Çavuşoğlu Y, Bekar L, Onrat E, Eren M, et al. Snapshot evaluation of heart failure in Turkey: Baseline characteristics of SELFIE-TR. Turk Kardiyol Dern Ars 2019; 47: 198-206.
9. Dickstein K, Normand C, Anker SD, Auricchio A, Blomström-Lundqvisit C, Bogale N, et al. European cardiac resynchronization therapy survey II: rationale and design. Europace 2015; 17: 137-41.
10. Dickstein K, Normand C, Auricchio A, Bogale N, Cleland JG, Gitt AK, et al. CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients-who is doing what to whom and how? Eur J Heart Fail 2018; 20: 1039-51.
11. Normand C, Linde C, Singh J, Dickstein K. Indications for Cardiac Resynchronization Therapy: A Comparison of the Major International Guidelines. JACC Heart Fail 2018; 6: 308-16.
12. Sears SF, Rosman L, Sasaki S, Kondo Y, Sterns LD, Schloss EJ, et al. Defibrillator shocks and their effect on objective and subjective patient outcomes: Results of the PainFree SST clinical trial. Heart Rhythm 2018; 15: 734-40.
13. Felker GM, Shaw LK, O'Connor CM. A standardized definition of ischemic cardiomyopathy for use in clinical research. J Am Coll Cardiol 2002; 39: 210-8.
14. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr., Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013; 62: e147-239.
15. Wilkoff BL, Fauchier L, Stiles MK, Morillo CA, Al-Khatib SM, Almendral J, et al. 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Europace 2016; 18: 159-83.
16. Bogdan S, Glikson M, Connolly SJ, Wang J, Hohnloser SH, Appl U, et al. Defibrillation testing and clinical outcomes after implantable cardioverter-defibrillator implantation in patients in atrial fibrillation at the time of implant: An analysis from the SIMPLE trial. Heart Rhythm 2019; 16: 83-90.

APA	Kocyigit Burunkaya D, Sarigul N, Altin A, Cay S, Polat V, saygi s, gümrükçüoğlu h, Gemici K, ikitimur b, Akyol A, BİLGE A, başarıcı i, Ozcan E, Demir M, KABUL H, Ornek E, Normand C, LInde C, dickstein k (2020). Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. , 382 - 396. 10.14744/AnatolJCardiol.2020.02680
Chicago	Kocyigit Burunkaya Duygu,Sarigul Nedim Umutay,Altin Ali Timucin,Cay Serkan,Polat Veli,saygi serkan,gümrükçüoğlu hasan ali,Gemici Kani,ikitimur baris,Akyol Ahmet,BİLGE AHMET KAYA,başarıcı ibrahim,Ozcan Emin Evren,Demir Mesut,KABUL Hasan Kutsi,Ornek Ender,Normand Camilla,LInde Cecilia,dickstein kenneth Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. (2020): 382 - 396. 10.14744/AnatolJCardiol.2020.02680
MLA	Kocyigit Burunkaya Duygu,Sarigul Nedim Umutay,Altin Ali Timucin,Cay Serkan,Polat Veli,saygi serkan,gümrükçüoğlu hasan ali,Gemici Kani,ikitimur baris,Akyol Ahmet,BİLGE AHMET KAYA,başarıcı ibrahim,Ozcan Emin Evren,Demir Mesut,KABUL Hasan Kutsi,Ornek Ender,Normand Camilla,LInde Cecilia,dickstein kenneth Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. , 2020, ss.382 - 396. 10.14744/AnatolJCardiol.2020.02680
AMA	Kocyigit Burunkaya D,Sarigul N,Altin A,Cay S,Polat V,saygi s,gümrükçüoğlu h,Gemici K,ikitimur b,Akyol A,BİLGE A,başarıcı i,Ozcan E,Demir M,KABUL H,Ornek E,Normand C,LInde C,dickstein k Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. . 2020; 382 - 396. 10.14744/AnatolJCardiol.2020.02680
Vancouver	Kocyigit Burunkaya D,Sarigul N,Altin A,Cay S,Polat V,saygi s,gümrükçüoğlu h,Gemici K,ikitimur b,Akyol A,BİLGE A,başarıcı i,Ozcan E,Demir M,KABUL H,Ornek E,Normand C,LInde C,dickstein k Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. . 2020; 382 - 396. 10.14744/AnatolJCardiol.2020.02680
IEEE	Kocyigit Burunkaya D,Sarigul N,Altin A,Cay S,Polat V,saygi s,gümrükçüoğlu h,Gemici K,ikitimur b,Akyol A,BİLGE A,başarıcı i,Ozcan E,Demir M,KABUL H,Ornek E,Normand C,LInde C,dickstein k "Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II." , ss.382 - 396, 2020. 10.14744/AnatolJCardiol.2020.02680
ISNAD	Kocyigit Burunkaya, Duygu vd. "Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II". (2020), 382-396. https://doi.org/10.14744/AnatolJCardiol.2020.02680

APA	Kocyigit Burunkaya D, Sarigul N, Altin A, Cay S, Polat V, saygi s, gümrükçüoğlu h, Gemici K, ikitimur b, Akyol A, BİLGE A, başarıcı i, Ozcan E, Demir M, KABUL H, Ornek E, Normand C, LInde C, dickstein k (2020). Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. The Anatolian Journal of Cardiology, 24(6), 382 - 396. 10.14744/AnatolJCardiol.2020.02680
Chicago	Kocyigit Burunkaya Duygu,Sarigul Nedim Umutay,Altin Ali Timucin,Cay Serkan,Polat Veli,saygi serkan,gümrükçüoğlu hasan ali,Gemici Kani,ikitimur baris,Akyol Ahmet,BİLGE AHMET KAYA,başarıcı ibrahim,Ozcan Emin Evren,Demir Mesut,KABUL Hasan Kutsi,Ornek Ender,Normand Camilla,LInde Cecilia,dickstein kenneth Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. The Anatolian Journal of Cardiology 24, no.6 (2020): 382 - 396. 10.14744/AnatolJCardiol.2020.02680
MLA	Kocyigit Burunkaya Duygu,Sarigul Nedim Umutay,Altin Ali Timucin,Cay Serkan,Polat Veli,saygi serkan,gümrükçüoğlu hasan ali,Gemici Kani,ikitimur baris,Akyol Ahmet,BİLGE AHMET KAYA,başarıcı ibrahim,Ozcan Emin Evren,Demir Mesut,KABUL Hasan Kutsi,Ornek Ender,Normand Camilla,LInde Cecilia,dickstein kenneth Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. The Anatolian Journal of Cardiology, vol.24, no.6, 2020, ss.382 - 396. 10.14744/AnatolJCardiol.2020.02680
AMA	Kocyigit Burunkaya D,Sarigul N,Altin A,Cay S,Polat V,saygi s,gümrükçüoğlu h,Gemici K,ikitimur b,Akyol A,BİLGE A,başarıcı i,Ozcan E,Demir M,KABUL H,Ornek E,Normand C,LInde C,dickstein k Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. The Anatolian Journal of Cardiology. 2020; 24(6): 382 - 396. 10.14744/AnatolJCardiol.2020.02680
Vancouver	Kocyigit Burunkaya D,Sarigul N,Altin A,Cay S,Polat V,saygi s,gümrükçüoğlu h,Gemici K,ikitimur b,Akyol A,BİLGE A,başarıcı i,Ozcan E,Demir M,KABUL H,Ornek E,Normand C,LInde C,dickstein k Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II. The Anatolian Journal of Cardiology. 2020; 24(6): 382 - 396. 10.14744/AnatolJCardiol.2020.02680
IEEE	Kocyigit Burunkaya D,Sarigul N,Altin A,Cay S,Polat V,saygi s,gümrükçüoğlu h,Gemici K,ikitimur b,Akyol A,BİLGE A,başarıcı i,Ozcan E,Demir M,KABUL H,Ornek E,Normand C,LInde C,dickstein k "Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II." The Anatolian Journal of Cardiology, 24, ss.382 - 396, 2020. 10.14744/AnatolJCardiol.2020.02680
ISNAD	Kocyigit Burunkaya, Duygu vd. "Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac ResynchronizationTherapy Survey-II". The Anatolian Journal of Cardiology 24/6 (2020), 382-396. https://doi.org/10.14744/AnatolJCardiol.2020.02680