Statistics on the use of cardiac electronic devices and electrophysiological procedures in 55 ESC countries: 2013 report from the European Heart Rhythm Association (EHRA)

In the last year, for the first time since its initiation, the EHRA White Book on the status of electrophysiology in the European Society of Cardiology (ESC) member countries was published as a full EP Europace supplement and in the form of comparative statistics. Since in the past editions neither comparisons nor trends and changes had been reported, we started to take this further step that was long awaited. The way in which the data are presented gives us the opportunity this year, for instance, to see the impact of new training initiatives, the foundation of working groups, the change in the number of practising centres, and so on. It also helps us to understand and estimate the impact of the economic crisis on the use of cost-intensive therapy such as ablation or pacemaker/implantable cardioverter defibrillator (ICD) implantation. Since the reliability of the data seems to increase with every year, we can base our evaluation on firmer grounds. The methodology has been previously reported.1 It also provides an idea on how reimbursement systems may affect the use of ICDs or implantable pulse generators (IPGs) in terms of reducing or increasing implant rates. The 2012 data in the 2013 edition in fact reveal changes in quite a considerable number of countries and show, for example, that in some countries from the eastern European area the implant rates for ICDs and IPGs by far exceed those of some western countries, meaning that the Gross Domestic Product (GDP) is not necessarily the driver for high or low rates of therapy use. Whereas IPG use and ICD implantations are something that has been widely used in the majority of countries at least for the strongest immediate life-saving indications, catheter ablation is used rather to treat symptoms and therefore would be most likely to …