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PLASMA Chile: A prospective, multicenter observational cohort study of patients with heart failure and reduced left

Rubén Aguayo1, Fernando Lanas2, Hugo Verdejo3

  • 1Servicio de Cardiología y Arritmias, Hospital San Juan de Dios, Santiago, RM, Chile.

Heart Rhythm O2
|January 16, 2026
PubMed

Insights

Patients with heart failure (HF) with reduced ejection fraction in Chile receive standard medications but face barriers to cardiac implantable electronic devices (CIEDs). These devices are underused, despite guidelines recommending them, impacting patient outcomes.

Area of Science:

  • Cardiology
  • Medical Devices
  • Public Health

Background:

  • Limited data exists on heart failure (HF) treatment in Chile, particularly for patients with reduced left ventricular ejection fraction (LVEF).
  • Understanding adherence to international guidelines and device utilization is crucial for improving patient care.

Purpose of the Study:

  • To evaluate adherence to 2017 AHA/ACC/HRS guideline recommendations for HF management.
  • To identify barriers to cardiac implantable electronic device (CIED) use in patients with HF and reduced LVEF.
  • To assess the association between CIED implantation and mortality in this population.

Main Methods:

  • A prospective, multicenter observational cohort study was conducted across 6 hospitals in Chile from March 2021 to December 2022.
  • Adult patients (≥18 years) with HF and LVEF ≤40% were enrolled, with sociodemographic, clinical, and treatment data collected.
  • Descriptive statistics and Cox univariable regression analyses were performed to evaluate outcomes.

Main Results:

  • The study included 243 patients with HF; 34.4% of eligible patients had a baseline CIED, with significant underutilization of recommended devices like implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds).
  • During follow-up, only 27 of 75 eligible patients received recommended ICD or CRT-D, with 38 patients facing access issues as a barrier.
  • No significant mortality differences were observed between patients with and without CIEDs, despite guideline recommendations.

Conclusions:

  • Patients in Chile with HF and reduced LVEF receive guideline-consistent pharmacological therapy.
  • Significant access barriers limit the utilization of CIEDs, which remain underused despite their proven benefits.
  • Further research is needed to address these barriers and optimize CIED implantation rates for improved HF management.
Abstract

Keywords:
ACC/AHA clinical guidelineCardiac implantable electronic deviceChileHeart failureReduced ejection fraction

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