title: A Comparative Survey of Pacemaker Implantation in Trinidad and Tobago in 2005 and 2009.
abstract: OBJECTIVE
  The indications for permanent pacemaker implantations in Trinidad have expanded from initially symptomatic bradycardia to now include complex devices. A retrospective review of the available data was conducted to better understand the evolving trends in device implantation in Trinidad and Tobago.
  
  
  METHODS
  Data were collated from the two major implanting teams in Trinidad for the years 2005 and 2009. The two implanting centres were the Advanced Cardiovascular Institute (ACI) at Westshore Medical Centre and the Catheterization Laboratory of the Eric Williams Medical Sciences Complex (EWMSC). Data were based on retrospective collation using the implantation records.
  
  
  RESULTS
  The implantation rate for new devices increased from 39 per million to 103 per million population. The most common indications for new device implants in 2009 were high degree atrioventricular (AV) block (53%) and sick sinus syndrome (22%) with the notable appearance of congestive cardiomyopathy (13%) which was not present in the earlier cohort. Of particular note, 23 high-end devices were implanted in 2009. These were five cardiac-resynchronization therapy (CRT-P) devices, 14 automatic implantable cardio-defibrillator (AICD) devices and four combined cardiac-resynchronization therapy with defibrillator (CRT-D) devices versus none in 2005.
  
  
  CONCLUSIONS
  In summary, over the period 2005 to 2009, a substantial increase in device implantation rates has occurred which now include high-end, complex devices. Absolute rates, however, remain far below that of developed countries, indicating that the true need remains underserved. Furthermore, adjustment for gross domestic product suggests that the relatively buoyant economy of Trinidad and Tobago is capable of servicing a greater proportion of this need than is currently met.
authors.affiliation: Advanced Cardiovascular Institute, 239 Western Main Road, Cocorite, Trinidad and Tobago; Doctors Inn Research Group, 109 Diego Martin Main Road, Diego Martin, Trinidad and Tobago. rhenry@dirg.co.tt.
authors.forename: R
authors.initials: R
authors.lastname: Henry
authors.affiliation: Advanced Cardiovascular Institute, 239 Western Main Road, Cocorite, Trinidad and Tobago.
authors.forename: T
authors.initials: T
authors.lastname: Dookie
authors.affiliation: Doctors Inn Research Group, 109 Diego Martin Main Road, Diego Martin, Trinidad and Tobago.
authors.forename: E
authors.initials: E
authors.lastname: Primus