EACVI survey on the role, structure, and implementation of heart teams in current cardiology practice.

Aims: The Heart Team (HT) concept is underscored in multiple guidelines, but the practical application is still challenging. Objective: This survey, endorsed by the European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee and conducted by the EACVI Leaders of Tomorrow, aimed to explore the structure and dynamics of contemporary HTs in real-life clinical practice. Methods and results: The Survey comprised 24 questions, including single-choice, multiple-choice, and open-labeled formats. It addressed all cardiologists and associated specialists involved in the HT meetings via online platform. A total of 233 responses were collected from 48 countries, 203 (87%) from Europe. Most respondents were imaging specialists (38%) and general cardiologists (29%), with 85% actively engaged in HT meetings. Twelve distinct HT configurations were identified. Core HT members included general and interventional cardiologists, cardiac surgeons, and imaging specialists. Complex cases are usually discussed at HT meetings, and ESC guidelines serve as a guiding framework (87%). Leadership within HTs is inconsistent and regular HT audits are lacking in 53% of centers. The Heart Team predominantly focus on treatment planning (97%) rather than outcome review (45%) or education (36%). Key perceived benefits include structured decision-making (74%), optimized management of complex cases (69%), and reduced specialty bias (67%). Recognized barriers included scheduling constraints, resource limitations, and communication inefficiencies. Conclusion: This survey shows the important role of multidisciplinary HTs in contemporary clinical practice but reveals several areas of potential improvement. Addressing common challenges could result in more efficient HT practices and improve the care of complex patient cases in various cardiology subspecialty areas.