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Archives of cardiovascular diseases
Volume 112, n° 11
pages 713-722 (novembre 2019)
Doi : 10.1016/j.acvd.2019.09.005
Received : 6 June 2019 ;  accepted : 9 September 2019
Clinical research

The European Society of Cardiology Cardiac Resynchronization Therapy Survey II: A comparison of cardiac resynchronization therapy implantation practice in Europe and France
The European Society of Cardiology Cardiac Resynchronization Therapy Survey II : une comparaison des pratiques en resynchronisation cardiaque en France et en Europe

Vincent Galand a, Cecilia Linde b, Nicolas Lellouche c, Jacques Mansourati d, Jean-Claude Deharo e, Pascal Sagnol f, Antoine Da Costa g, Jerome Horvilleur h, Pascal Defaye i, Serge Boveda j, Mathieu Steinbach k, Paul Bru l, Philippe Rumeau m, Thierry Beard n, Salem Younsi o, Kenneth Dickstein p, q, Camilla Normand p, q, Christophe Leclercq r,
a LTSI-UMR 1099, Rennes University, CHU de Rennes, 35000 Rennes, France 
b Heart and Vascular Theme, Karolinska University Hospital and Karolinska Institute, 17176 Stockholm, Sweden 
c Henri-Mondor Hospital, 94101 Créteil, France 
d Department of Cardiology, CHU de Brest, 29200 Brest, France 
e Department of Cardiology, CHU de La Timone, 13385 Marseille, France 
f Department of Cardiology, centre hospitalier William-Morey, 71321 Chalon-sur-Saône, France 
g Department of Cardiology, CHU de Saint-Étienne, 42270 Saint-Priest-en-Jarez, France 
h Department of Cardiology, Paris South Cardiovascular Institute, 91300 Massy, France 
i Department of Cardiology, Michallon Hospital, CHU Grenoble Alpes, 38700 La Tronche, France 
j Department of Cardiology, Clinique Pasteur, 31076 Toulouse, France 
k Department of Cardiology, centre hositalier de Haguenau, 67500 Haguenau, France 
l Department of Cardiologie, centre hositalier de La Rochelle, 17019 La Rochelle, France 
m Department of Cardiology, centre hositalier de Albi, 81000 Albi, France 
n Department of Cardiology, Ormeau Polyclinic, 65000 Tarbes, France 
o Department of Cardiology, Antoine-Béclère Hospital, 92140 Clamart, France 
p Cardiology Division, Stavanger University Hospital, 4011 Stavanger, Norway 
q Institute of Internal Medicine, University of Bergen, 5021 Bergen, Norway 
r Department of Cardiology and Vascular Diseases, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France 

Corresponding author.

The first European Cardiac Resynchronization Therapy (CRT) Survey, conducted in 2008–2009, showed considerable variations in guideline adherence and implantation practice. A second prospective survey (CRT Survey II) was then performed to describe contemporary clinical practice regarding CRT among 42 European countries.


To compare the characteristics of French CRT recipients with the overall European population of CRT Survey II.


Demographic and procedural data from French centres recruiting all consecutive patients undergoing either de novo CRT implantation or an upgrade to a CRT system were collected and compared with data from the European population.


A total of 11,088 patients were enrolled in CRT Survey II, 754 of whom were recruited in France. French patients were older (44.7% aged75 years vs 31.1% in the European group), had less severe heart failure symptoms, a higher baseline left ventricular ejection fraction and fewer co-morbidities. Additionally, French patients had a shorter intrinsic QRS duration (19.1% had a QRS<130ms vs 12.3% in the European cohort). Successful implantation rates were similar, but procedural and fluoroscopy times were shorter in France. French patients were more likely to receive a CRT pacemaker than European patients overall. Of note, antibiotic prophylaxis was reported to be administered less frequently in France, and a higher rate of early device-related infection was observed. Importantly, French patients were less likely to receive optimal drugs for treating heart failure at hospital discharge.


This study highlights contemporary clinical practice in France, and describes substantial differences in patient selection, implantation procedure and outcomes compared with the other European countries participating in CRT Survey II.

The full text of this article is available in PDF format.

La première enquête européenne sur la resynchronisation cardiaque (CRT) conduite entre 2008 et 2009 a montré d’importantes différences entre les pays participants en terme de pratiques cliniques et suivi des recommandations. Une deuxième étude prospective et incluant 42 pays a été réalisée afin de décrire plus précisément cette pratique clinique en Europe.


L’objectif est de comparer les caractéristiques de la population française implantée d’une CRT à l’ensemble de la population européenne.


Les caractéristiques des patients et des procédures ont été collectées. Les patients recevant un primo-implantation ou un upgrade en CRT ont été inclus dans cette étude et comparés à la population européenne.


Au total, 11 088 patients ont été inclus dans cette étude, et 754 sont Français. Les patients français étaient plus âgés (44,7 % avaient>75 ans vs 31,1 % en Europe), moins symptomatiques, avaient une fraction d’éjection plus élevée et moins de co-morbidités. Les patients français présentaient également une durée de QRS plus court (19,1 % avec un QRS<130ms vs 12,3 % des patients européens). Le taux de succès d’implantation était similaire entre les 2 groupes mais avec un temps de procédure et de fluoroscopie plus court en France. À noter qu’en France, moins de patients ont été déclarés avoir reçu une antibioprophylaxie avant procédure et ont présenté un taux plus élevé d’infection précoce. Enfin, les Français reçoivent moins fréquemment un traitement optimal de l’insuffisance cardiaque à la sortie de l’hôpital.


Cette étude montre des différences substantielles par rapport à la population européenne, en termes de sélection de patients, d’implantation et de résultats précoces.

The full text of this article is available in PDF format.

Keywords : Cardiac resynchronization therapy, Survey, Heart failure, Europe population, French population

Mots clés : Registre, Insuffisance cardiaque, Population européennes, Population française

Abbreviations : AF, CRT, CRT-P, CRT-D, ESC, HF, ICD, LVEF, NYHA

© 2019  Published by Elsevier Masson SAS.
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