title: Tracing the European course of cardiac resynchronization therapy from 2006 to 2008.
abstract: Cardiac resynchronization therapy (CRT) is a highly efficient treatment modality for patients with severe congestive heart failure and intraventricular dyssynchrony. However, the high individual cost and technical complexity of the implantation may limit its widespread utilization. The European Heart Rhythm Association (EHRA) launched a project to assess treatment of arrhythmias in all European Society of Cardiology member countries in order to have a platform for a progressive harmonization of arrhythmia treatment. As a result, two EHRA White Books have been published in 2008 and 2009 based on governmental, insurance, and professional society data. Our aim was to analyse the local differences in the utilization of CRT, based on these surveys. A total of 41 countries provided enough data to analyse years 2006-2008. Significant differences were found in the overall number of implantations and the growth rate between 2006 and 2008. Other contributing factors include local reimbursement of CRT, the existence of national guidelines, and a high number of conventional implantable cardioverter-defibrillator implantations, while GDP or healthcare spending has less effect. Focusing on improving these factors may increase the availability of CRT in countries where it is currently underutilized.
authors.affiliation: Heart Centre, Semmelweis University, Varosmajor utca 68, Budapest H-1122, Hungary. merkely.bela@kardio.sote.hu
authors.forename: Bela
authors.initials: B
authors.lastname: Merkely
authors.forename: Attila
authors.initials: A
authors.lastname: Roka
authors.forename: Valentina
authors.initials: V
authors.lastname: Kutyifa
authors.forename: Lucas
authors.initials: L
authors.lastname: Boersma
authors.forename: Antoine
authors.initials: A
authors.lastname: Leenhardt
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lubinski
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
mesh_terms: D001145:Arrhythmias, Cardiac / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000191:economics / Q000379:methods / Q000639:trends*; D003625:Data Collection; D017147:Defibrillators, Implantable / Q000191:economics / Q000706:statistics & numerical data*; D005060:Europe; D006291:Health Policy; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D007391:International Cooperation; D010138:Pacemaker, Artificial / Q000191:economics / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies