Impact of socioeconomic aspects on cardiac implantable electronic device treatment and application of the EHRA guidelines

Bannehr, Marwin; Reiners, David; Lichtenauer, Michael; Kopp, Kristen; Jirak, Peter; Georgi, Christian; Butter, Christian; Edlinger, Christoph

doi:10.1007/s00508-022-02056-5

Cited by 3 publications

(6 citation statements)

References 25 publications

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“…Higher implantation numbers correlate moderately with a higher GDP and higher health expenditure. The Czech Republic is somewhere in the middle and is similar to Spain (95.3 per 100.000 inhabitants) and Luxembourg (91.7 per 100.000 inhabitants) (9).…”

Section: Discussionmentioning

confidence: 95%

Clinical characteristics and mortality in all Czech patients after pacemaker implantation in the last decade

Táborský,

Skála,

Dušek

et al. 2023

Front. Cardiovasc. Med.

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Background and aimsAnalysis of mortality from the national health registries and data from a specific central registry dealing with the implantation of pacemakers (REPACE) in Czech patients.Methods and resultsRetrospective observational analysis of pacemakers’ implantation in all Czech patients [n = 82,791; 47,070 (56.9%) men, 75.9 ± 10.4 years old] between 2010 and 2021. Almost 114,000 pacemakers were implanted between 2010 and 2021, of which 27.9% were single-chamber, 67.4% were dual-chamber and 4.6% were biventricular. The annual number of implantations has been steadily increasing with a 6% annual decline in 2020 with increased mortality and reductions in care provided, likely related to COVID-19. The observed 5-year relative survival was 88.6% (overall survival 60.6%) and the 10-year relative survival was 75.9% (overall survival 32.7%). Causes of death 5ary according to the age of the patient. The highest difference 1n the reported numbers in the REPACE Registry did not exceed 2% in comparison with the National Register of Reimbursed Health Services.ConclusionThis study followed all Czech patients with pacemaker’s implantation in between 2010 and 2021. The annual number of 1mplantations has been steadily 1ncreasing. Patients with implanted pacemakers had a significantly higher mortality than the average population. Number of patients in the registry corresponded almost perfectly with the National Register of Reimbursed Health Services.

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Section: Discussionmentioning

confidence: 95%

Clinical characteristics and mortality in all Czech patients after pacemaker implantation in the last decade

Táborský,

Skála,

Dušek

et al. 2023

Front. Cardiovasc. Med.

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“…The numbers of CRT implantations per 100,000 inhabitants, as well as the healthcare expenditure per 100,000 inhabitants, were calculated using data from the 2017 EHRA White Book , as described in detail in previous studies [ 9 ]. A graphical illustration of the strongly varying implantation figures within Europe can be found in Figure 1 .…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, the European Heart Rhythm Association (EHRA) regularly publishes a report on implantation figures in the respective EHRA member countries in the form of the EHRA White Book [ 8 ]. Looking at the 2017 EHRA White Book , it is striking that there are extreme intra-European differences, even if obvious reasons, such as the socioeconomic status of the individual countries, are disregarded [ 9 ]. This is especially true for implantation rates in the German-speaking countries: Germany, Austria and Switzerland.…”

Section: Introductionmentioning

confidence: 99%

“…The aim of the present study was to further analyse the differences in implantation rates within Europe using a qualitative research approach. For this purpose, German-speaking countries were selected because they have comparable socioeconomic conditions and similar medical infrastructure [ 9 ]. Semi-standardized interviews were conducted with leading experts in the field of CRT in Germany, Austria and Switzerland to identify explanatory models for the extreme differences in implantation rates within these countries.…”

Section: Introductionmentioning

confidence: 99%

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Which Factors Influence the Immensely Fluctuating CRT Implantation Rates in Europe? A Mixed Methods Approach Using Qualitative Content Analysis Based on Expert Interviews

Edlinger

Bannehr

Georgi

et al. 2023

JCM

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(1) Background: Cardiac resynchronisation therapy (CRT) is nowadays an indispensable treatment option for heart failure. Although the indication is subject to clear cross-national guidelines by the European Society of Cardiology (ESC), there is immense variation in the number of implantations per 100,000 inhabitants in Europe, especially in German-speaking countries (Germany, Austria and Switzerland). The aim of the present study was to identify possible factors for these differences using a qualitative research approach. (2) Methods: Semi-standardized interviews were conducted with 11 experts in the field of CRT therapy (3 experts from Germany, 4 from Austria and 4 from Switzerland) using a pre-prepared interview template and analysed according to Mayring’s qualitative content analysis. (3) Results: The main factors identified were the costs of purchasing the devices and the financing systems of the respective healthcare systems, although cost pressure still seems to play a subordinate role in the German-speaking countries. Moreover, “lack of implementation of ESC guidelines”, “insufficient training” and “lack of medical infrastructure” could be excluded as potential reasons. (4) Conclusions: Economic factors, but not a lack of adherence to ESC guidelines, seem to have a major influence on the fluctuating implantation figures in German-speaking countries, according to the unanimous assessment of renowned experts.

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“…However, CIED utilization and implantation trends are far from uniform. An analysis of the EHRA 2017 white book results focusing on the impact of socioeconomic aspects of CIED applications revealed that European implant numbers varied significantly, with Germany implanting the most devices (196.53 implants per 100,000 inhabitants) and Kosovo the least (2.81 implants per 100,000 inhabitants) [19]. Higher implant numbers correlated with higher national gross domestic product (r = 0.456; p = 0.002) and higher health care expenditures (r = 0.586; p < 0.001) [19].…”

Section: Trends In Cardiac Device Implantationmentioning

confidence: 99%

Paradigm Shifts in Cardiac Pacing: Where Have We Been and What Lies Ahead?

Ballantyne

Chew

Vandenberk

2023

JCM

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The history of cardiac pacing dates back to the 1930s with externalized pacing and has evolved to incorporate transvenous, multi-lead, or even leadless devices. Annual implantation rates of cardiac implantable electronic devices have increased since the introduction of the implantable system, likely related to expanding indications, and increasing global life expectancy and aging demographics. Here, we summarize the relevant literature on cardiac pacing to demonstrate the enormous impact it has had within the field of cardiology. Further, we look forward to the future of cardiac pacing, including conduction system pacing and leadless pacing strategies.

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Impact of socioeconomic aspects on cardiac implantable electronic device treatment and application of the EHRA guidelines

Cited by 3 publications

References 25 publications

Clinical characteristics and mortality in all Czech patients after pacemaker implantation in the last decade

Clinical characteristics and mortality in all Czech patients after pacemaker implantation in the last decade

Which Factors Influence the Immensely Fluctuating CRT Implantation Rates in Europe? A Mixed Methods Approach Using Qualitative Content Analysis Based on Expert Interviews

Paradigm Shifts in Cardiac Pacing: Where Have We Been and What Lies Ahead?

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