Swiss national cardiac device registry: Changing trends in implantation procedures over the last two decades

Background The Swiss National Device Registry (SwissEPnet) provides a comprehensive database for implantation procedures. The purpose of this study was to provide an in-depth look at device statistics and changing trends over the last 20 years. Methods The database was analyzed between January 1, 2003 and December 31, 2022. Results: During the study period, 124,458 pacemaker and cardiac resynchronization therapy (CRT) procedures (mean age: 77.7 years; 59.7% male) were performed in 73 centers while 29,133 implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy with defibrillator (CRT-D) procedures (mean age: 63.63 years; 80.2% male) were performed in 56 centers in Switzerland. While the number of pacemaker procedures has doubled in 20 years and there has been a constant increase in the mean age of patients receiving a pacemaker, the number of ICD procedures has more than tripled and recently plateaued with a mean age which has remained stable. Fluoroscopy and procedure durations remained stable over time for pacemaker and ICD procedures. Newer technologies, leadless pacemakers and CRT procedures require more fluoroscopy time, but this has also decreased over time. While regular battery changes remained stable, the proportion of DDD and CRT upgrades increased. The overall reintervention rate due to device-associated infections was stable over time. Conclusions There was a pronounced increase in the number of pacemaker procedures in Switzerland in the last two decades and a marked increase in ICD procedures, which have plateaued recently. Overall, there is a constant increase in mean age of patients receiving a pacemaker, while the mean age of patients receiving an ICD did not change during follow up.