Guideline-directed device therapies in heart failure: A clinical practice-based analysis using electronic health record data.

Background: Guideline-directed device therapies (GDDT) improve outcomes for eligible patients with heart failure (HF) with reduced ejection fraction (HFrEF). Utilization rates of device therapies in HFrEF after the 2012 ACCF/AHA/HRS Focused Update for Device-based Therapies of Cardiac Rhythm Abnormalities have not been well studied.

Objective: Characterize the use of GDDT in newly indicated HFrEF patients from 2012 to 2019 using aggregated electronic health record (EHR) data.

Guideline-concordant-phenotyping: Identifying patient indications for implantable cardioverter defibrillators from electronic health records.

Background: Implantable cardioverter-defibrillators (ICDs) have been shown to reduce sudden cardiac death in appropriately selected patients, but they remain underutilized among indicated patients.

Objective: To develop a new approach to identifying guideline indications among patients implanted with ICDs by creating algorithms that extract data from electronic health records (EHR).

Methods: Published guidelines providing recommendations for ICD use were distilled into categories of diagnoses, measures, procedures, and terminologies.

Cardiac resynchronization therapy in chronic heart failure with moderately reduced left ventricular ejection fraction: Lessons from the Multicenter InSync Randomized Clinical Evaluation MIRACLE EF study.

Background: The benefits of CRT for symptomatic heart failure (HF) patients with a wide QRS and reduced left ventricular ejection fraction (LVEF≤35%), are well established .Post-hoc subgroup analyses suggest that CRT benefit may extend to patients with LVEF>35%.

Methods: The MIRACLE EF was a prospective, randomized, controlled, double-blinded study to evaluate CRT-P in NYHA II-III HF patients with LBBB and with LVEF of 36%-50% and no previous pacing or ICD.