Cardiac Resynchronisation Therapy in New Zealand

Abstract

Background: The All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) Device registry is a national registry designed to collect data on all cardiac implantable electronic devices implanted in New Zealand (NZ). This study aimed to provide a contemporary analysis comparing the clinical characteristics of patients receiving cardiac resynchronisation therapy pacemakers (CRT-P) and primary prevention cardiac resynchronisation therapy defibrillators (CRT-D). Method: Complete datasets of CRT-P and primary prevention CRT-D implants from the ANZACS-QI DEVICE registry from 1 January 2014 to 31 December 2017 were analysed. Results: A total of 175 CRT-P and 155 primary prevention CRT-D implants were identified. Patients who received CRT-P were older (median age, 74 vs 66 y) and more likely to be female (38.3% vs 19.4%). There was a higher proportion of Māori patients in the CRT-D group (16.1% vs 8.6%). Patients receiving a CRT-D had longer mean QRS duration (169.2 ms vs 160.8 ms) and poorer left ventricular function (mean LVEF 24.2% vs 28.7%). There was a history of atrial fibrillation in 39.4% - 42.3%, 87.5% - 88.6% had New York Heart Association II - III symptoms, and 87.7% - 89.1% had left bundle branch block. Left ventricular lead position in the CRT-D cohort was most common in the mid-ventricular, posterolateral position. Conclusion: This analysis provides contemporary data on CRT use in NZ. Compared with primary prevention CRT-D, patients receiving CRT-P were older and more likely to be female.