The cardiac resynchronisation therapy (CRT) survey II is a joint initiative between the European Heart Rhythm Association and the Heart Failure Association. It compiles real world data about cardiac resynchronisation therapy in European Society of Cardiology member states. 11 088 patients assigned to implantation of CRT with pacemaker function (CRT-P) or CRT with an incorporated defibrillator (CRT-D) were enrolled in the survey starting 1 October 2015 till 31 December 2016 and for each patient, an electronic case report form (eCRF) was completed. Each participating country had each eCRF data-point benchmarked against the total cohort. In total, 79 patients were included from Latvia. The mean age of patients was 68.1, similar to the total cohort of other ESC member states, and 21.8% of patients were female. Latvian patients compared to other countries more often had permanent atrial fibrillation, NYHA class III and IV, ejection fraction 35 %. CRT-Ds and multipolar lead implantation rates were higher. Peri-procedural complication rates were similarly low in both groups. At discharge, prescribed medication rates were similar but more frequently MRAs, ivabradine and calcium channel blockers were prescribed and slightly less frequently ACE inhibitors/ARBs were prescribed. The CRT survey II is a valuable resource that describes ongoing practice of cardiac resynchronisation therapy around Europe and benchmarking against the total cohort is nationally significant for each participating country.
The aim of this study was to evaluate treatment of patients with moderate and severe heart failure (HF) who were resistant to pharmacotherapy in Latvia and to assess the cardiac resynchronisation therapy (CRT) by exploring the predisposing factors which provides CRT efficacy. We accomplished prospective analysis of left ventricle ejection fraction (LVEF) and other parameter changes 12 and 24 months after CRT device implantation, dividing the population into two groups: responders — to whom LVEF improvement was ≥10% and non-responders where ≥ 10% LVEF improvement was not achieved. The study included 50 chronic HF patients with preserved sinus rhythm, who underwent CRT device implantation in Latvia at the Pauls Stradiņš Clinical University Hospital from June 2009 to March 2012. In the group of patients where 12 and 24 months after CRT device implantation LVEF improvement ≥10% was achieved, there were statistically significantly more patients with left bundle branch block (LBBB) QRS morphology, wider QRS complex, nonischemic genesis of HF, and normal systolic blood pressure. Patients with LVEF improvement had more pronounced ventricular dyssynchrony measured by Echo before CRT device implantation and, accordingly, the CRT mode was programmed as left ventricle paced before right ventricle and close to 100% biventricular pacing was achieved and the patient was female.
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