Cardiac resynchronization therapy-heart failure (CRT-HF) clinic: A novel model of care


Autoři: Eiran Z. Gorodeski aff001;  Christina Magnelli-Reyes aff002;  Laurie Ann Moennich aff003;  Adam Grimaldi aff002;  John Rickard aff002
Působiště autorů: Section of Heart Failure and Cardiac Transplantation, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, United States of America aff001;  Section of Cardiac Pacing and Electrophysiology, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, United States of America aff002;  Heart and Vascular Research, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, United States of America aff003
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222610

Souhrn

Background

Post-implant care of patients with heart failure (HF) undergoing cardiac resynchronization therapy (CRT) is not addressed in current HF or CRT guidelines and is often fragmented with poor communication between specialties. We sought to develop a new model of post-CRT care which could be implemented in busy clinical settings.

Methods and results

We designed a novel, multidisciplinary approach to standardizing post CRT care. All patients receiving a CRT device at the Cleveland Clinic between March 2017 and August 2018 were invited to be seen in the clinic 6 months post implant. A one-time collaborative visit encompassing cardiac imaging, heart failure, and electrophysiology care was performed. We recorded the operational feasibility of the clinic in terms of patient throughput as well as patient characteristics, interventions, and new diagnoses made. Between September 2017 and February 2019, 150 patients were seen in the clinic. Of these, 125 patients had their index CRT implanted for standard indications and were included in the current analysis. Approximately 45 minutes were dedicated for each patient visit. Interventions in care were made in 95% of patients, with CRT non-responders offered a higher number of interventions as compared to responders (median 3 versus 2 interventions). Types of interventions were device-related (26% of population), medication-related (74%), and referral for alternate medical services (80%).

Conclusions

Multidisciplinary post-implant care of patients with HF receiving CRT devices, regardless of CRT response status, is feasible and results in frequent medical interventions.

Klíčová slova:

Medicine and health sciences – Cardiology – Heart failure – Cardiac pacing – Health care – Quality of life – Biology and life sciences – Bioengineering – Biotechnology – Medical devices and equipment – Medical implants – Engineering and technology – Research and analysis methods – Bioassays and physiological analysis – Electrophysiological techniques – Cardiac electrophysiology – Electrocardiography


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 9

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