Referrers and Implanters: Two Views of Partial-Support MCS in Europe
In advanced heart failure, the physician who implants a device is rarely the one who first sees the patient.
A company developing a partial-support mechanical circulatory support device wanted to understand how European cardiologists would view it and which patients might benefit.
The recruit targeted two distinct groups:
Heart failure cardiologists in heart centers, managing end-stage NYHA class IIIB and IV patients who are candidates for a left ventricular assist device (LVAD) or transplant
Clinical cardiologists in non-heart centers, managing patients across NYHA classes I to IV and referring advanced cases on
Interviews took place at the ESC Congress in Paris. Each lasted one hour, and every respondent saw the same adverse event profile for the device.
The final sample was 20: 12 heart failure cardiologists and eight clinical cardiologists. By country, 10 were from Germany, eight from the UK and two from Italy. The clinical cardiologist group included two interventional cardiologists, an office-based cardiologist and a hypertension specialist.
Including referrers was key. They see patients earlier in the disease course, when a partial-support device might be considered, and their decisions determine which patients reach a heart center.
Both groups saw a need for a partial-support device. The interviews also showed physicians tended to fall into one of two treatment philosophies, liberal or conservative, with little middle ground.
A parallel US study let the client compare the two markets directly.
