Implementation of device therapy (cardiac resynchronization therapy and implantable cardioverter defibrillator) for patients with heart failure in Europe: changes from 2004 to 2008.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
van Veldhuisen
Dirk J
DJ
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. d.j.van.veldhuisen@thorax.umcg.nl
Maass
Alexander H
AH
Priori
Silvia G
SG
Stolt
Pelle
P
van Gelder
Isabelle C
IC
Dickstein
Kenneth
K
Swedberg
Karl
K
D017147:Defibrillators, Implantable / Q000639:trends*; D005060:Europe; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D010138:Pacemaker, Artificial / Q000639:trends*