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Europace. 2022 Jan 04;24(1):165-172. doi: 10.1093/europace/euab193.

European Society of Cardiology Quality Indicators for the care and outcomes of cardiac pacing: developed by the Working Group for Cardiac Pacing Quality Indicators in collaboration with the European Heart Rhythm Association of the European Society of Cardiology.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

Suleman Aktaa, Amr Abdin, Elena Arbelo, Haran Burri, Kevin Vernooy, Carina Blomström-Lundqvist, Giuseppe Boriani, Pascal Defaye, Jean-Claude Deharo, Inga Drossart, Dan Foldager, Michael R Gold, Jens Brock Johansen, Francisco Leyva, Cecilia Linde, Yoav Michowitz, Mads Brix Kronborg, David Slotwiner, Torkel Steen, José Maria Tolosana, Stylianos Tzeis, Niraj Varma, Michael Glikson, Jens Cosedis Nielsen, Chris P Gale

Affiliations

  1. Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.
  2. Leeds Institute for Data Analytics and Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
  3. Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  4. Internal Medicine Clinic III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital, Homburg/Saar, Germany.
  5. Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
  6. Institut d'Investigacións Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
  7. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
  8. Cardiology Department, Geneva University Hospital, Geneva, Switzerland.
  9. Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), Maastricht, the Netherlands.
  10. Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden.
  11. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
  12. Department of Cardiology, Arrhythmias Unit, University Hospital Grenoble Alps and Grenoble Alps University, Grenoble, France.
  13. Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France.
  14. Service de Cardiologie, Hôpital de la Timone, APHM, Marseille, France.
  15. Drossart (Belguim), ESC Patient Forum, Sophia Antipolis.
  16. Foldager(Denmark), ESC Patient Forum, Sophia Antipolis, France.
  17. Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA.
  18. Department of Cardiology, Odense University Hospital, Odense, Denmark.
  19. Department of Cardiology, Aston Medical School, Aston University, Birmingham, UK.
  20. Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK.
  21. Department of Medicine, Karolinska Institute, Solna, Sweden.
  22. Department of Cardiology, Karolinska University Hospital, Solna, Sweden.
  23. Cardiology Department, Shaare Zedek Hospital, Affiliated to the Faculty of Medicine, Hebrew University, Jerusalem, Israel.
  24. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  25. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  26. Cardiology Division, Weill Cornell Medical College, New York, NY, USA.
  27. Centre for Pacemakers and ICDs, Oslo University Hospital Ullevaal, Oslo, Norway.
  28. Cardiology Department, Mitera General Hospital, Hygeia Group, Athens, Greece.
  29. Cleveland Clinic, Cleveland, OH, USA.

PMID: 34455442 DOI: 10.1093/europace/euab193

Abstract

AIMS: To develop a suite of quality indicators (QIs) for the evaluation of the care and outcomes for adults undergoing cardiac pacing.

METHODS AND RESULTS: Under the auspice of the Clinical Practice Guideline Quality Indicator Committee of the European Society of Cardiology (ESC), the Working Group for cardiac pacing QIs was formed. The Group comprised Task Force members of the 2021 ESC Clinical Practice Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy, members of the European Heart Rhythm Association, international cardiac device experts, and patient representatives. We followed the ESC methodology for QI development, which involved (i) the identification of the key domains of care by constructing a conceptual framework of the management of patients receiving cardiac pacing, (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. Four domains of care were identified: (i) structural framework, (ii) patient assessment, (iii) pacing strategy, and (iv) clinical outcomes. In total, seven main and four secondary QIs were selected across these domains and were embedded within the 2021 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization therapy.

CONCLUSION: By way of a standardized process, 11 QIs for cardiac pacing were developed. These indicators may be used to quantify adherence to guideline-recommended clinical practice and have the potential to improve the care and outcomes of patients receiving cardiac pacemakers.

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

Keywords: Cardiac pacemaker; Clinical practice guidelines; Quality indicators

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