European Journal of Heart Failure Advance Access originally published online on November 1, 2009
European Journal of Heart Failure 2009 11(12):1143-1151; doi:10.1093/eurjhf/hfp149
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Implementation of device therapy (cardiac resynchronization therapy and implantable cardioverter defibrillator) for patients with heart failure in Europe: changes from 2004 to 2008
1 Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700RB Groningen, The Netherlands
2 University of Pavia, Fondazione Salvatore Maugeri, Pavia, Italy
3 Medtronic Europe, Tolchenaz, Switzerland
4 Stavanger University Hospital, University of Bergen, Norway
5 University of Gothenborg, Göteborg, Sweden
* Corresponding author. Tel: +31 50 3612355, Fax: +31 50 3614391, Email: d.j.van.veldhuisen{at}thorax.umcg.nl
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Abstract |
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Aims: Heart failure (HF) patients increasingly receive device therapy, either an implantable cardioverter defibrillator (ICD) or a biventricular pacemaker, also called cardiac resynchronization therapy (CRT), or a CRT device with an ICD (CRT-D). However, epidemiological data on the use of device therapy in Europe are limited.
Methods and results: Data on implantation rates for conventional pacemakers, ICD, CRT, and CRT-D in 15 Western European countries were obtained from the Eucomed Registry for the 5-year period 2004–2008. Implantation of conventional pacemakers increased by 9% in Europe over the 5 years (reaching 907/million in 2008) and there were significant differences between countries. Implantable cardioverter defibrillator implantations increased by 75% from 80/million in 2004 to 140/million in 2008, and differences between countries were larger than those for conventional pacemakers. Implantation rates for CRT-P alone increased slightly from 2004 to 2006, but remained at 25/million thereafter in Europe overall. The total number of CRT implants (CRT-P and -D) markedly increased from 46/million in 2004 to 99/million in 2008 (115%), but this was mainly due to more CRT-D implants, i.e. an increase in the proportion of CRT-D (from 55% in 2004 to 75% in 2008). Implantation rates for ICD, CRT, and CRT-D remained markedly different throughout the study period between countries.
Conclusion: Implantation rates of devices for HF, in particular ICD and CRT-D, have increased significantly between 2004 and 2008 in Europe, but there remain major differences between countries.
Key Words: Heart failure • Device therapy • ICD • CRT • Implementation • Geographic differences
Received July 21, 2009; Revised September 11, 2009; Accepted September 24, 2009