Do we differ in indications and demographics in cardiac resynchronization recipients in Poland? Insights from the European CRT Survey II Registry

Background: Multiple randomized clinical trials have proved that cardiac resynchronization therapy (CRT) reduces morbidity and mortality in appropriately selected patients with congestive heart failure and is recommended for such patients as per the European Society of Cardiology (ESC) guidelines. Aims: In this paper we compare indications and demographics in cardiac resynchronization recipients in Poland and other European countries. Methods: In 2015 and 2016, physicians from 42 European countries participated in the second edition of the European Cardiac Resynchronization Therapy Survey. For 14 months, 288 implant centres gathered data on 11088 patients regarding demography, indications, implanting methods, and guidance compatibility from patients receiving CRT. Results: The survey indicated a vast group of patients as having qualified for CRT implantation (some of them with relatively weak guidance recommendations) and showed essential variety in clinical practice when national data was benchmarked. Conclusions: As far as demographic data from the survey is concerned, it can be generally assumed that patients receiving CRT were mainly men with depressed left ventricular ejection fraction (mostly less than 35%), with left bundle branch block (LBBB), and an intrinsic QRS duration of more than 150 ms. This was observed for both Poland and other European countries and fulfils the guidance criteria for CRT implantation. On the other hand, some devices were implanted in patients beyond the guideline recommendations. For these procedures, the decision regarding CRT implantation relies mainly on the physicians’ experience.