Cardiac Resynchronization Therapy (CRT) in Algeria, result of ESC CRT Survey II

Abstract

Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) in ischemic and non-ischemic cardiomyopathy (NIDM) with widened QRS interval, and only being used in Algeria since ten years later. Describe the current clinical practice regarding CRT in Algeria and compare each data point with the total cohort of patients included in ESC CRT Survey II. From 1st October 2015 to 31 December 2016, all patients admitted for CRT implantation were included, even if unsuccessful procedure; generator replacements or revisions of existing CRT devices were excluded. The ESC web-based e-CRF used for data collection was developed by Institut für Herzinfarktforschung Ludwigshafen (IHF), which also conducted data management and statistical analysis. Sixty-six patients (57.8 ± 10.2 years old, 2/3 male, 170 ± 23ms QRS width, 77, 3% non-ischemic cardiomyopathy) were recruited, of which 41% had heart failure hospitalization during past year with 3% being upgrades. Comorbidities reported were hypertension (34, 8%), valvular heart desease(12,1%), diabetes(31.8%), anemia (25,8%) chronic kidney disease (16,7%). The procedures were performed successfully in 90% (60/66) pts, mostly CRT-P in 56, 7% (34/60), and in 96, 7% use of multipolar leads placed in lateral position. The operator was mostly an electro physiologist (96, 7%, 58/60 pts). The main reason of procedure failure was unsuccessful LV lead placement. No death occurred; pneumothorax (3%) and coronary dissection (3%) were the most common complications. Patients discharged were treated with ACE inhibitor/ARB, 97% beta blocker, 90% MRA and 95, 5% loop diuretic. Experienced centers in Algeria report high success rate of CRT implants, mostly primo-CRT P implantation with use of multipolar leads, low complication rates. Patients mostly had non ischemic cardiomyopathy, and were less old with fewer co morbidities than ESC survey patients.