Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study
Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter regist...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Daniel Bonhorst [verfasserIn] Sara Guerreiro [verfasserIn] Cândida Fonseca [verfasserIn] Nuno Cardim [verfasserIn] Filipe Macedo [verfasserIn] Pedro Adragão [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Übergeordnetes Werk: |
In: Revista Portuguesa de Cardiologia (English Edition) - Elsevier, 2020, 38(2019), 1, Seite 33-41 |
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| Übergeordnetes Werk: |
volume:38 ; year:2019 ; number:1 ; pages:33-41 |
| Links: |
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| DOI / URN: |
10.1016/j.repce.2018.04.012 |
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| Katalog-ID: |
DOAJ070638586 |
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| 520 | |a Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento | ||
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10.1016/j.repce.2018.04.012 doi (DE-627)DOAJ070638586 (DE-599)DOAJ035844071df247d1a0eb838fb3bea568 DE-627 ger DE-627 rakwb eng RC666-701 Daniel Bonhorst verfasserin aut Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento Diseases of the circulatory (Cardiovascular) system Sara Guerreiro verfasserin aut Cândida Fonseca verfasserin aut Nuno Cardim verfasserin aut Filipe Macedo verfasserin aut Pedro Adragão verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 38(2019), 1, Seite 33-41 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:38 year:2019 number:1 pages:33-41 https://doi.org/10.1016/j.repce.2018.04.012 kostenfrei https://doaj.org/article/035844071df247d1a0eb838fb3bea568 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204919300029 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 38 2019 1 33-41 |
| spelling |
10.1016/j.repce.2018.04.012 doi (DE-627)DOAJ070638586 (DE-599)DOAJ035844071df247d1a0eb838fb3bea568 DE-627 ger DE-627 rakwb eng RC666-701 Daniel Bonhorst verfasserin aut Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento Diseases of the circulatory (Cardiovascular) system Sara Guerreiro verfasserin aut Cândida Fonseca verfasserin aut Nuno Cardim verfasserin aut Filipe Macedo verfasserin aut Pedro Adragão verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 38(2019), 1, Seite 33-41 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:38 year:2019 number:1 pages:33-41 https://doi.org/10.1016/j.repce.2018.04.012 kostenfrei https://doaj.org/article/035844071df247d1a0eb838fb3bea568 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204919300029 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 38 2019 1 33-41 |
| allfields_unstemmed |
10.1016/j.repce.2018.04.012 doi (DE-627)DOAJ070638586 (DE-599)DOAJ035844071df247d1a0eb838fb3bea568 DE-627 ger DE-627 rakwb eng RC666-701 Daniel Bonhorst verfasserin aut Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento Diseases of the circulatory (Cardiovascular) system Sara Guerreiro verfasserin aut Cândida Fonseca verfasserin aut Nuno Cardim verfasserin aut Filipe Macedo verfasserin aut Pedro Adragão verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 38(2019), 1, Seite 33-41 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:38 year:2019 number:1 pages:33-41 https://doi.org/10.1016/j.repce.2018.04.012 kostenfrei https://doaj.org/article/035844071df247d1a0eb838fb3bea568 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204919300029 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 38 2019 1 33-41 |
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10.1016/j.repce.2018.04.012 doi (DE-627)DOAJ070638586 (DE-599)DOAJ035844071df247d1a0eb838fb3bea568 DE-627 ger DE-627 rakwb eng RC666-701 Daniel Bonhorst verfasserin aut Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento Diseases of the circulatory (Cardiovascular) system Sara Guerreiro verfasserin aut Cândida Fonseca verfasserin aut Nuno Cardim verfasserin aut Filipe Macedo verfasserin aut Pedro Adragão verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 38(2019), 1, Seite 33-41 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:38 year:2019 number:1 pages:33-41 https://doi.org/10.1016/j.repce.2018.04.012 kostenfrei https://doaj.org/article/035844071df247d1a0eb838fb3bea568 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204919300029 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 38 2019 1 33-41 |
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10.1016/j.repce.2018.04.012 doi (DE-627)DOAJ070638586 (DE-599)DOAJ035844071df247d1a0eb838fb3bea568 DE-627 ger DE-627 rakwb eng RC666-701 Daniel Bonhorst verfasserin aut Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento Diseases of the circulatory (Cardiovascular) system Sara Guerreiro verfasserin aut Cândida Fonseca verfasserin aut Nuno Cardim verfasserin aut Filipe Macedo verfasserin aut Pedro Adragão verfasserin aut In Revista Portuguesa de Cardiologia (English Edition) Elsevier, 2020 38(2019), 1, Seite 33-41 (DE-627)684129663 (DE-600)2646972-8 21742049 nnns volume:38 year:2019 number:1 pages:33-41 https://doi.org/10.1016/j.repce.2018.04.012 kostenfrei https://doaj.org/article/035844071df247d1a0eb838fb3bea568 kostenfrei http://www.sciencedirect.com/science/article/pii/S2174204919300029 kostenfrei https://doaj.org/toc/2174-2049 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_647 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 38 2019 1 33-41 |
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Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. 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real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – the síncrone study |
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Real-life data on heart failure before and after implantation of resynchronization and/or defibrillation devices – The Síncrone study |
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Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento |
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Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento |
| abstract_unstemmed |
Introduction: The aim of this study was to document clinical practice in Portugal regarding the use of electronic cardiac devices in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento |
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Methods: The Síncrone study was an observational prospective multicenter registry conducted in 16 centers in Portugal between 2006 and 2014. It included adult patients with a diagnosis of HF, LVEF <35% and indication for implantable cardioverter-defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices, according to the recommendations of the European Society of Cardiology at the beginning of the study. Patients were followed for one year according to the practice of each center. Results: A total of 486 patients were included in the registry, half of whom received an ICD and the other half a CRT pacemaker (CRT-P) or CRT defibrillator (CRT-D). Mean age was 65±12 years and the most frequent causes of HF were ischemic (47%) and idiopathic dilated cardiomyopathy (28%). Overall mortality at one year was 3.6% and the hospitalization rate was 11%, significantly higher in patients with CRT-P/CRT-D than with ICD (17% vs. 5.6%, p<0.001). Patients who received CRT-P/CRT-D experienced significant reductions in QRS duration (160±21 vs. 141±24 ms, p<0.001) as well as improvement in New York Heart Association functional class. Conclusion: The Síncrone study shows that the use of implantable devices in HF with reduced LVEF in Portugal is in accordance with international recommendations and that patients presented functional improvement and reduced one-year mortality. Resumo: Introdução: O objetivo deste registo foi caracterizar a prática clínica em Portugal no que respeita à utilização de dispositivos eletrónicos na terapêutica dos doentes com insuficiência cardíaca (IC) e fração de ejeção ventricular esquerda (FEVE) diminuída. Métodos: O estudo Síncrone é um registo observacional, multicêntrico e prospetivo que foi conduzido em 16 centros portugueses de 2006 a 2014. Incluiu doentes adultos com diagnóstico de IC, FEVE < 35% e indicação para implantação de dispositivos de desfibrilhação (CDI) e/ou ressincronização (CRT), de acordo com as recomendações da Sociedade Europeia de Cardiologia em vigor aquando do início do estudo. Os doentes foram seguidos durante um ano, de acordo com a prática de cada centro. Resultados: No total, foram incluídos 486 doentes, dos quais metade implantou CDI e a outra metade CRT-P ou CRT-D. A idade média foi de 65 ± 12 anos e as etiologias mais frequentes foram a isquémica (47%) e a miocardiopatia dilatada idiopática (28%). A mortalidade global ao ano foi 3,6% e a taxa de reinternamento 11%, sendo significativamente maior nos doentes que implantaram CRT-D/CRT-P em relação aos que implantaram CDI (17% versus 5,6% p < 0,001). Nos doentes submetidos a CRT observou-se redução significativa da duração do QRS (160 ± 21 ms versus 141 ± 24 ms, p < 0,001), bem como melhoria da classe funcional New York Heart Association. Conclusão: O estudo Síncrone mostra que a utilização dos dispositivos implantáveis na IC com FEVE diminuída está de acordo com as recomendações internacionais, tendo os doentes apresentado melhoria funcional e reduzida mortalidade ao ano. Keywords: Heart failure, Reduced left ventricular ejection fraction, Resynchronization, Implantable cardiac devices, Mortality, Hospitalization, Palavras-chave: Insuficiência Cardíaca, Fração de ejeção ventricular esquerda diminuída, Ressincronização, Dispositivos cardíacos implantáveis, Mortalidade, Reinternamento</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the circulatory (Cardiovascular) system</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Sara Guerreiro</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Cândida Fonseca</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Nuno Cardim</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" 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