Determinants of geographic variations in implantation of cardiac defibrillators in the European Society of Cardiology member countries-data from the European Heart Rhythm Association White Book

作者：Lubinski Andrzej; Bissinger Andrzej^*; Boersma Lucas; Leenhardt Antoine; Merkely Bela; Oto Ali; Proclemer Alessandro; Brugada Josep; Vardas Panos E; Wolpert Christian

来源：Europace, 2011, 13(5): 654-662.

DOI：10.1093/europace/eur066

• Implantable cardioverter defibrillator
• Geographic variations
• Implantation rate
• Europe
• Reimbursement
• Healthcare expenses

Aims Sudden cardiac death (SCD) is a major health concern in developed countries. Many studies have demonstrated the efficacy of implantable cardioverter defibrillator (ICD) therapy in the prevention of SCD and total mortality reduction. However, the high individual costs and the reimbursement policy may limit widespread ICD utilization.
Methods and results This study analyzed the temporal and the geographical trends of the ICD implantation rate. Data were gathered from two editions of the European Heart Rhythm Association (EHRA) White Books published in 2008 and 2009. The analysis revealed significant differences in the rates of ICD implantation per million capita between the countries, but the median implantations was constantly increasing. The number of ICD implantations correlated with gross domestic product (GDP), GDP per capita, expenditure on health, life expectancy, and the number of implanting centres.
Conclusion There are great number of differences in the ICD-implanting rates between EHRA member countries, consequent to the increase in the number of ICD implantations. The ICD implantation rates are related to national economic status and healthcare expenses.

• 出版日期2011-5