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Review
. 2023 Feb 8;25(1):199-210.
doi: 10.1093/europace/euac114.

European Society of Cardiology quality indicators for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Suleman Aktaa  1   2   3 , Stylianos Tzeis  4 , Chris P Gale  1   2   3 , Michael J Ackerman  5 , Elena Arbelo  6   7   8 , Elijah R Behr  9   10 , Lia Crotti  11   12 , Andre d'Avila  13 , Christian de Chillou  14 , Thomas Deneke  15 , Márcio Figueiredo  16 , Tim Friede  17 , Christophe Leclercq  18 , Jose L Merino  19 , Chris Semsarian  20   21   22 , Axel Verstrael  23 , Katja Zeppenfeld  24 , Jacob Tfelt-Hansen  25   26 , Tobias Reichlin  27
Affiliations
Review

European Society of Cardiology quality indicators for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Suleman Aktaa et al. Europace. .

Abstract

To develop a suite of quality indicators (QIs) for the management of patients with ventricular arrhythmias (VA) and the prevention of sudden cardiac death (SCD). The Working Group comprised experts in heart rhythm management including Task Force members of the 2022 European Society of Cardiology (ESC) Clinical Practice Guidelines for the management of patients with VA and the prevention of SCD, members of the European Heart Rhythm Association, international experts, and a patient representative. We followed the ESC methodology for QI development, which involves (i) the identification of the key domains of care for the management of patients with VA and the prevention of SCD by constructing a conceptual framework of care, (ii) the development of candidate QIs by conducting a systematic review of the literature, (iii) the selection of the final set of QIs using a modified-Delphi method, and (iv) the evaluation of the feasibility of the developed QIs. We identified eight domains of care for the management of patients with VA and the prevention of SCD: (i) structural framework, (ii) screening and diagnosis, (iii) risk stratification, (iv) patient education and lifestyle modification, (v) pharmacological treatment, (vi) device therapy, (vii) catheter ablation, and (viii) outcomes, which included 17 main and 4 secondary QIs across these domains. Following a standardized methodology, we developed 21 QIs for the management of patients with VA and the prevention of SCD. The implementation of these QIs will improve the care and outcomes of patients with VA and contribute to the prevention of SCD.

Keywords: Accountability; Clinical practice guidelines; Outcomes; Quality indicators; Sudden cardiac death; Treatment; Ventricular arrhythmias.

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Conflict of interest statement

Conflict of interest: M.J.A. is a consultant for Abbott, Boston Scientific, Bristol Myers Squibb, Daichii Sankyo, Invitae, LQT Therapeutics, and Medtronic. M.J.A. and/or Mayo Clinic are involved in an equity/intellectual property/royalty relationship with AliveCor, Anumana, ARMGO Pharma, Pfizer, and UpToDate. However, none of these entities were involved in this study. T.D. receives from InHeart—Speaker honoraria, personal (< 5.000€), Siemens—Speaker Honoraria, institutional (< 5.000€), Biotronik—Educational Course Director, personal (< 10.000€), Abbott—Speaker honoraria, personal (< 5.000€) and Boston Scientific—Adverse events committee, personal (< 5.000€). CPG Chair of the Data Science Group of EuroHeart, Deputy Editor of EHJ Quality of Care and Clinical Outcomes. Unrelated to the present work: Research grants from Abbott, BMS, BHF, Horizon 2020, NIHR; speaker’s honoraria from AstraZeneca, Raisio Group, Wondr Medical; Consulting from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Ely-Lilly, Menarini, Vifor outside the submitted work.

Figures

Figure 1
Figure 1
Conceptual framework for the management of patients with ventricular arrhythmia and sudden cardiac death prevention. CMR = cardiac magnetic resonance, ETT = exercise tolerance test, EP = electrophysiology, ICD = implantable cardioverter-defibrillator, PM = post-mortem, SCD = sudden cardiac death, TM = telemonitoring, VA = ventricular arrhythmias.
Figure 2
Figure 2
2022 ESC EHRA QIs for VA and SCD prevention. ARVC = arrhythmogenic right ventricular cardiomyopathy, BB = beta-blockers, CMR = cardiac magnetic resonance, CA = catheter ablation, CIED = cardiac implantable electronic devices, CPR = cardiopulmonary resuscitation, CRT-D = cardiac resynchronization therapy-defibrillator, DC = discharge, ESC = European Society of Cardiology, HCM = hypertrophic cardiomyopathy, ICD = implantable cardioverter-defibrillator, LGE = late gadolinium enhancement, LQTS = long QT syndrome, OHCA = out-of-hospital cardiac arrest, SCD = sudden cardiac death, VA = ventricular arrhythmia, VT = ventricular tachycardia.
Figure 3
Figure 3
Preferred reporting items for systematic reviews and meta-analyses flowchart for the systematic review.
See this image and copyright information in PMC

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