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Profiling cardiac arrhythmia and heart failure patients in India: The Pan-arrhythmia and Heart Failure Observational
Amit Vora1, Ajay Naik2, Yash Lokhandwala3
1Glenmark Cardiac Centre, Mumbai, India.
Insights
The PANARM HF registry in India found many cardiac arrhythmia and heart failure patients needed device therapy but few were referred or received it. This highlights gaps in interventional cardiology referral and treatment pathways for these conditions.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- The PANARrhythMia and Heart Failure Registry (PANARM HF) was established to understand patient profiles in India.
- It focused on demographic, clinical, and interventional therapy indications for cardiac arrhythmia (CA) and heart failure (HF) patients.
Purpose of the Study:
- To characterize the demographic and clinical profiles of CA and HF patients in India.
- To investigate interventional therapy indications, referral patterns, and consultation processes for these patients.
Main Methods:
- Consulting Physicians (CPs) enrolled 2205 CA/HF patients across 12 Indian cities.
- CPs were trained by interventional cardiologists (ICs) to identify patients eligible for implantable devices or radiofrequency ablation (RFA).
- Data collected included patient demographics, clinical status, and indications for device/RFA therapy.
Main Results:
- Heart failure (58%) was most common, followed by bradyarrhythmia and atrial fibrillation (15% each).
- Coronary artery disease (52%), hypertension (44%), and diabetes (30%) were prevalent comorbidities.
- Only 177 out of 1011 potential device/RFA candidates (46% of total patients) were ultimately recommended therapy by ICs, with 83% not receiving or opting for it.
Conclusions:
- The PANARM HF study provides critical insights into the management of CA/HF patients in India.
- It reveals significant gaps in the referral and treatment pathways for indicated interventional therapies.
- Understanding these patterns is crucial for improving patient outcomes in India.
Background:
The PANARrhythMia and Heart Failure Registry (PANARM HF) characterized demographic, clinical and interventional therapy indication profiles of cardiac arrhythmia (CA) and heart failure (HF) patients in India.
Methods:
Consulting Physicians (CP) who medically manage CA and HF patients enrolled patients with one or more of the following: syncope, pre-syncope, dyspnea, palpitation, fatigue and LV dysfunction. The CPs were trained by interventional cardiologists (IC) to identify CA/HF patients indicated for implantable device/radiofrequency ablation (RFA). 59 CP's, 16 IC's & 2205 patients from 12 cities participated. Demographic, clinical, device/RFA indication and referral-consultation profiles were created. IC's provided device/RFA recommendations based on these profiles.
Results:
The CA/HF distribution of patients was: HF - 58%, bradyarrhythmia - 15%, atrial fibrillation - 15%, other supraventricular tachyarrhythmia - 10% and ventricular tachycardia/fibrillation - 4.5%. 62% of the CA/HF population was male and 45% were below age 60. Coronary artery disease (52%), hypertension (44%), diabetes (30%) & myocardial infarction (20%) were prominent. 1011 (46%) of the CA/HF population were potential device/RFA candidates according to the IC's. However, only 700 (69%) of these patients were referred to the IC by the CP. Of referred patients, only 177 (25%) consulted the IC and were recommended therapy. Thus, 824 (83%) of patients indicated for interventional therapy were not advised therapy or did not opt for it.
Conclusion:
The India PANARM HF study provides new information and insights into the demographic, clinical, interventional therapy, referral and consultation pattern profiles of CA/HF patients in India.
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