title: [The pacemaker and implantable cardioverter-defibrillator registry of the Italian Association Arrhythmology Cardiac Pacing and cardiac pacing - annual report 2013].
abstract: BACKGROUND
  The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2013 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers.
  
  
  METHODS
  The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards.
  
  
  RESULTS
  PM Registry: data about 25 419 PM implantations were collected (19 134 first implant and 6285 replacements). The number of collaborating centers was 275. Median age of treated patients was 80 years (74 quartile I; 86 quartile III). ECG indications included atrioventricular conduction disorders in 43.6% of first PM implants, sick sinus syndrome in 24.7%, atrial fibrillation plus bradycardia in 12.9%, other in 18.8%. Among atrioventricular conduction defects, third-degree atrioventricular block was the most common type (23.2% of first implants). Use of single-chamber PMs was reported in 27.2% of first implants, of dual-chamber PMs in 62.6%, of PMs with cardiac resynchronization therapy (CRT) in 1.8%, and of single lead atrial-synchronized ventricular stimulation (VDD/R PMs) in 8.4%. ICD Registry: data about 16 519 ICD implantations were collected (11 474 first implants and 5045 replacements). The number of collaborating centers was 430. Median age of treated patients was 71 years (63 quartile I; 77 quartile III). Primary prevention indication was reported in 76% of first implants, secondary prevention in 24.0% (cardiac arrest in 7.8%). A single-chamber ICD was used in 27.2% of first implants, dual-chamber in 35.9% and biventricular in 36.8%.
  
  
  CONCLUSIONS
  The PM and ICD Registry appears fundamental for monitoring PM and ICD utilization on a large national scale with rigorous examination of demographics and clinical indications. The PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The use of CRT-PM regards a very limited number of patients. The ICD Registry documented a constant increase in prophylactic and biventricular ICD use, reflecting a favorable adherence to trials and guidelines in clinical practice.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
authors.forename: Massimo
authors.initials: M
authors.lastname: Zecchin
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Onofrio
authors.forename: Giovanni Luca
authors.initials: GL
authors.lastname: Botto
authors.forename: Luca
authors.initials: L
authors.lastname: Rebellato
authors.forename: Marco
authors.initials: M
authors.lastname: Ghidina
authors.forename: Giulia
authors.initials: G
authors.lastname: Bianco
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bernardelli
authors.forename: Elsa
authors.initials: E
authors.lastname: Pucher
authors.forename: Dario
authors.initials: D
authors.lastname: Gregori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy*; D003299:Cooperative Behavior; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D019983:Guideline Adherence; D006801:Humans; D007558:Italy; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012042:Registries; D012955:Societies, Medical