Gaps Between Eastern and Western Europe

Photo: Europe

The highest implantation rates
were reported in Germany (326)
and the Czech Republic (270);

Data is primarily provided by the national cardiology societies and working groups of cardiac pacing and electrophysiology of each ESC country. Prospective data is collected on catheter ablation and on implantation of cardiovascular implantable electronic devices including implantable pulse generators (IPGs, also called pacemakers), implantable cardiac defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices.

The analysis revealed healthcare inequalities in the treatment of different arrhythmic disorders across Europe and the 54 ESC countries, within established economies and within emerging economies, and growing gaps.

“The treatment gaps were not solely due to a country’s economic status but were also the result of a lack of implanting centres, properly trained healthcare professionals and low referral rates,” said Professor Angelo Auricchio. “Just throwing money at the issue will not solve the problem. Training and adherence to guidelines are needed.”

The analysis revealed that in 2011, across ESC member countries, an average of 604 IPGs were implanted per million inhabitants. The highest implantation rates were in Germany (1,313), Italy (1,034) and Iceland (1,006) and the lowest rates were in Azerbaijan (15), Morocco (39) and Georgia (84).

In ESC member countries the average number of ICD implantations per million inhabitants was 103 in 2011. The highest implantation rates were reported in Germany (326) and the Czech Republic (270). The lowest implantation rates were reported in Ukraine (1), Morocco (1) and Azerbaijan (2).

For CRT the average number of implants per million inhabitants in ESC member countries was 77 in 2011. The highest rates were in Italy (203), Germany (202) and Denmark (158), with the lowest rates in Morocco (1), Ukraine (1) and Azerbaijan (2). CRT implantation numbers were low in non-EU27 countries. Implant numbers were not correlated with average healthcare spending or GDP but were correlated with device reimbursement, the number of implant centres, and the lack of availability and poor implementation of local guidelines. The report said: “Focusing on changing local policies to achieve a more uniform approach to CRT, and bringing experience to these countries may increase implant numbers and decrease the persisting, significant geographical differences.”

Health expenditure per capita ranged between 143 Dollars in Armenia and 9,603 Dollars in Switzerland, a 67-fold difference. Reduced health expenditure was associated with lower use of interventional electrophysiological procedures.; Source: European Society of Cardiology (ESC)