title: Statistics on the use of cardiac electronic devices and electrophysiological procedures in the European Society of Cardiology countries: 2014 report from the European Heart Rhythm Association.
abstract: OBJECTIVE
  There has been large variations in the use of invasive electrophysiological therapies in the member countries of the European Society of Cardiology (ESC). The aim of this analysis was to provide comprehensive information on cardiac implantable electronic device (CIED) and catheter ablation therapy trends in the ESC countries over the last five years.
  
  
  METHODS
  The European Heart Rhythm Association (EHRA) has collected data on CIED and catheter ablation therapy since 2008. Last year 49 of the 56 ESC member countries provided data for the EHRA White Book. This analysis is based on the current and previous editions of the EHRA White Book. Data on procedure rates together with information on economic aspects, local reimbursement systems and training activities are presented for each ESC country and the five geographical ESC regions.
  
  
  RESULTS
  In 2013, the electrophysiological procedure rates per million population were highest in Western Europe followed by the Southern and Northern European countries. The CIED implantation and catheter ablation rate was lowest in the Eastern European and in the non-European ESC countries, respectively. However, in some Eastern European countries with relative low gross domestic product procedure rates exceeded those of some wealthier Western countries, suggesting that economic resources are not the only driver for utilization of arrhythmia therapies.
  
  
  CONCLUSIONS
  These statistics indicate that despite significant improvements, there still is considerable heterogeneity in the availability of arrhythmia therapies across the ESC area. Hopefully, these data will help identify areas for improvement and guide future activities in cardiac arrhythmia management.
authors.affiliation: Department of Medicine Division of Cardiology, Central Finland Health Care District, Jyväskylä and University of Eastern Finland, Building 1 D/9, FI-40620 Jyväskylä, Finland pekka.raatikainen@ksshp.fi.
authors.forename: M J Pekka
authors.initials: MJ
authors.lastname: Raatikainen
authors.affiliation: The Heart Centre, Department of Medicine, Landspitali - The National University Hospital, Reykjavik, Iceland.
authors.forename: David O
authors.initials: DO
authors.lastname: Arnar
authors.affiliation: Department of Cardiology, Leiden University Medical Centre, Leiden, Netherlands.
authors.forename: Katja
authors.initials: K
authors.lastname: Zeppenfeld
authors.affiliation: Unidad Electrofisiologia Cardiaca Robotizada-Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Merino
authors.affiliation: Centre for Cardiovascular Sciences, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK.
authors.forename: Francisco
authors.initials: F
authors.lastname: Levya
authors.affiliation: Department of Electrophysiology, Heart Centre, University of Leipzig, Leipzig, Germany.
authors.forename: Gerhardt
authors.initials: G
authors.lastname: Hindriks
authors.affiliation: Deparment of Cardiology, Ak St. Georg, Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
mesh_terms: D001281:Atrial Fibrillation / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000706:statistics & numerical data*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D002568:Certification; D003625:Data Collection; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D022062:Electrophysiologic Techniques, Cardiac / Q000706:statistics & numerical data*; D005060:Europe; D005061:Europe, Eastern; D059066:Gross Domestic Product; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: Atrial fibrillation ablation; Cardiac resynchronization pacemaker (CRT-P); Cardiac resynchronization therapy defibrillator (CRT-D); Catheter ablation; Implantable cardioverter defibrillator (ICD); Pacemaker