title: Barriers to implementation of evidence-based electrical therapies and the need for outcome research: role of European registries.
abstract: Although clinical trial results and the implementation of current guidelines appear to have encouraged progress in the treatment of arrhythmias, great discrepancies still exist between European Society of Cardiology (ESC) member countries. Guidelines are not adhered to for a variety of reasons. This cannot be explained only by economic factors, although these obviously play a substantial role. Other factors responsible for adequate guideline implementation appear to be the lack of trained personnel, the lack of infrastructure, or different health insurance systems. In this complex scenario, the data based on European registries are useful for creating standards and harmonizing the treatment of arrhythmias. Moreover, a summary of registry data, such as presented in the European Heart Rhythm Association (EHRA) White Book, can provide the opportunity to share and exchange information among ESC member countries on specific needs for improvements, reimbursement policy, and training issues.
authors.affiliation: Klinikum Ludwigsburg, Department of Medicine-Cardiology, Ludwigsburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lubinski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Bissinger
authors.forename: Bela
authors.initials: B
authors.lastname: Merkely
authors.forename: Silvia
authors.initials: S
authors.lastname: Priori
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
mesh_terms: D001145:Arrhythmias, Cardiac / Q000517:prevention & control*; D001291:Attitude of Health Personnel; D035843:Biomedical Research / Q000639:trends; D002309:Cardiology / Q000706:statistics & numerical data; D004599:Electric Stimulation Therapy / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*