Current trends in the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology member countries: 2015 report from the European Heart Rhythm Association.
OBJECTIVE
The aim was to provide comprehensive information on the use of cardiac implantable electronic device (CIED) and catheter ablation therapy in the European Society of Cardiology (ESC) area.


RESULTS
The European Heart Rhythm Association (EHRA) has collected data on use of invasive arrhythmia managements since 2008. Fifty-one of the 56 ESC member countries provided data for the EHRA White Book 2015. This analysis is based on the current and previous editions of the EHRA White Book. Up-to-date information on procedure rates for the last 5 years together with information on economic resources, reimbursement systems, and training requirements are presented for each country and the five geographical ESC regions. In 2014, the CIED implantation rates per million population were highest in the Western followed by the Southern and Northern European countries. The catheter ablation activity was largest in the Western followed by the Northern and Southern areas. Altogether the procedure rates were lowest in the Eastern European and in the non-European ESC countries. In the European ESC countries, the procedure rates were 3-10 times higher than in the non-European ESC countries. However, in some countries with a relatively low gross domestic product the procedure rates exceeded the average values indicating that utilization of arrhythmia therapies was not driven merely by the economic factors.


CONCLUSIONS
This analysis indicates that considerable heterogeneity in the availability and utilization of arrhythmia therapies still exist across the ESC area. The data will hopefully aid in directing future activities and promote harmonization of cardiac arrhythmia care in the ESC countries.
Department of Medicine Division of Cardiology, Central Finland Health Care District, Jyväskylä and University of Eastern Finland, Building 1 D/9, FI-40620 Jyväskylä, Kuopio, Finland pekka.raatikainen@fimnet.fi.
M J Pekka
MJ
Raatikainen
The Heart Centre, Department of Medicine, Landspitali - The National University Hospital, Reykjavik, Iceland.
David O
DO
Arnar
Department of Cardiology, Leiden University Medical Centre, Leiden, Netherlands.
Katja
K
Zeppenfeld
Unidad Electrofisiologia Cardiaca Robotizada-Hospital Universitario La Paz, Madrid, Spain.
Jose Luis
JL
Merino
Department of Cardiology, Ak St. Georg, Hamburg, Germany.
Karl-Heinz
KH
Kuck
Department of Electrophysiology, Heart Centre, University of Leipzig, Leipzig, Germany.
Gerhardt
G
Hindricks
D001145:Arrhythmias, Cardiac / Q000628:therapy*; D058406:Cardiac Resynchronization Therapy / Q000639:trends*; D002309:Cardiology; D017115:Catheter Ablation / Q000639:trends*; D017147:Defibrillators, Implantable / Q000639:trends*; D022062:Electrophysiologic Techniques, Cardiac; D005060:Europe; D006801:Humans
Atrial fibrillation ablation; Cardiac resynchronization therapy defibrillator (CRT-D); Cardiac resynchronization therapy pacemaker (CRT-P); Catheter ablation; Implantable cardioverter-defibrillator (ICD); Pacemaker