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Volume : 25 Issue : 6 Year : 2021
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Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac Resynchronization Therapy Survey-II [Anatol J Cardiol]
Anatol J Cardiol. 2020; 24(6): 382-396 | DOI: 10.14744/AnatolJCardiol.2020.02680

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

Duygu Koçyiğit1, Nedim Umutay Sarıgül2, Ali Timuçin Altın3, Serkan Çay4, Veli Polat5, Serkan Saygı6, Hasan Ali Gümrükçüoğlu7, Kani Gemici8, Barış İkitimur9, Ahmet Akyol10, Ahmet Kaya Bilge11, İbrahim Başarıcı12, Emin Evren Özcan13, Mesut Demir14, Hasan Kutsi Kabul15, Ender Ornek16, Camilla Normand17, Cecilia Linde18, Kenneth Dickstein17
1Department of Cardiology, Faculty of Medicine, Hacettepe University; Ankara-Turkey
2Department of Cardiology, Medical Park Göztepe Hospital; İstanbul-Turkey
3Department of Cardiology, Faculty of Medicine, Ankara University; Ankara-Turkey
4Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Yüksek İhtisas Heart-Education and Research Hospital; Ankara-Turkey
5Department of Cardiology, University of Health Sciences, Bakırköy Sadi Konuk Training and Research Hospital; İstanbul-Turkey
6Department of Cardiology, Medical Park İzmir Hospital; İzmir-Turkey
7Department of Cardiology, Lokman Hekim Hospital; Van-Turkey
8Department of Cardiology, Memorial Hospital; İstanbul-Turkey
9Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
10Department of Cardiology, Faculty of Medicine, Acıbadem Mehmet Ali Aydınlar University, Acıbadem Maslak Hospital; İstanbul-Turkey
11Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University; İstanbul-Turkey
12Department of Cardiology, Faculty of Medicine, Akdeniz University; Antalya-Turkey
13Department of Cardiology, Faculty of Medicine, Dokuz Eylül University; İzmir-Turkey
14Department of Cardiology, Faculty of Medicine, Çukurova University; Adana-Turkey
15Department of Cardiology, University of Health Sciences, Gülhane Education and Research Hospital; Ankara-Turkey
16Department of Cardiology, University of Health Sciences, Ankara City Hospital; Ankara-Turkey
17Division of Cardiology, Stavanger University Hospital; Stavanger-Norway; Institute of Internal Medicine, University of Bergen; Bergen-Norway
18Heart and Vascular Theme, Karolinska University Hospital and Karolinska Institutet; Stockholm-Sweden

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 compare 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 implantations. 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.

Keywords: cardiac resynchronization therapy, epidemiological survey, heart failure

Duygu Koçyiğit, Nedim Umutay Sarıgül, Ali Timuçin Altın, Serkan Çay, Veli Polat, Serkan Saygı, Hasan Ali Gümrükçüoğlu, Kani Gemici, Barış İkitimur, Ahmet Akyol, Ahmet Kaya Bilge, İbrahim Başarıcı, Emin Evren Özcan, Mesut Demir, Hasan Kutsi Kabul, Ender Ornek, Camilla Normand, Cecilia Linde, Kenneth Dickstein. Current clinical practice of cardiac resynchronization therapy in Turkey: Reflections from Cardiac Resynchronization Therapy Survey-II. Anatol J Cardiol. 2020; 24(6): 382-396

Corresponding Author: Nedim Umutay Sarıgül, Germany