Do cardiologists follow the European guidelines for cardiac pacing and resynchronization therapy? Results of the European Heart Rhythm Association survey

The purpose of this European Heart Rhythm Association (EHRA) EP wire survey was to evaluate the implementation of the current guidelines for cardiac pacing and cardiac resynchronization therapy (CRT) in Europe. A total of 48 centres replied to the survey, 34 of them (71%) were university hospitals. All responding centres implement CRT in patients with classical indications, i.e. sinus rhythm, New York Heart Association (NYHA) functional class II, III, or ambulatory IV, left ventricular ejection fraction (LVEF) 35%, and left bundle-branch block (LBBB) with QRS duration >150 ms, while 31 centres (67%) would implant a CRT device in patients with the same characteristics but with a non-LBBB pattern. Forty-one centres (89%) would also implant CRT in patients with sinus rhythm, NYHA Class II, III, or ambulatory IV, LVEF <35%, and LBBB with QRS duration between 120 and 150 ms, while only eight centres (17%) would implant the device in patients with the same characteristics but with a non-LBBB pattern. In patients with LVEF <35% and QRS duration below 120 ms, the majority of the centres (80%) would implant a single- or dual-chamber implantable cardioverter-defibrillator, but in nine cases (20%) no device was considered to be indicated. The results of this survey showed a good adherence to some of the current recommendations. Still some reluctance exists when offering the device therapy to patients with QRS duration in the lower range. © 2014 Published on behalf of the European Society of Cardiology

Standards for device implantation and follow-up: Personnel, equipment, and facilities: Results of the European Heart Rhythm Association Survey

Cardiac device implantation is the most common of all invasive cardiac electrophysiological procedures. Over 250 000 devices are implanted each year in Europe. The purpose of this European Heart Rhythm Association (EHRA) survey was to assess the facilities, personnel, and protocols of members of the EHRA electrophysiology (EP) research network involved in device implantation. There were 68 responses to the questionnaire. The survey responses were mainly (84%) from medium- to high-volume device implanting centres, performing >200 implants per year, with over 50% performing >400 implants per year. Most consultants are male (85%), half of all centres had no female consultants, and only one in six had more than one female consultant. There is trend towards specialization in device implantation. The combination of device implantation and EP is still common (76% of all centres) but only 34% of centres have consultants performing device implantation and coronary intervention. Moreover, 23% of centres have all device implantation performed by consultants who do not perform any other types of procedure. Cardiac device implantation as a day case is the planned admission for routine elective device implantation in 30% of hospitals, 47% of hospitals have a single night stay, and 23% of hospitals have admission durations of two or more nights. Device implantation is available as a 24 h service, 365 days a year in 38% of hospitals. The commonest other model was as a daytime service on weekdays in 45% of hospitals. © 2014 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014