The world survey of cardiac pacing and implantable cardioverter defibrillators: Calendar year 1997 - Europe

The registry of the European Working Group on Cardiac Pacing (EWGCP) is bas ed on the European Pacemaker Identification Card originally designed in Jul y 1978. National registration centers collect the local data and send aggre gated annual data to the EWGCP. For 1997, data were obtained from 2,887 hos pitals in 20 European countries representing a population of 568 million. A cross all participating countries, the median value for all implanted pacem akers was 378 per million population. For initial pacemaker implants, the m edian value was 290 per million population. Single chamber atrial pacing wa s important in Denmark, the Netherlands, Poland, Slovak Republic, Spain, an d Sweden for the treatment of sick sinus syndrome. Dual chamber pacing acco unted for < 50% of initial implants in only 5 of 14 countries for atriovent ricular block, and in only 3 of 15 countries for sick sinus syndrome. In 7 of 15 countries, unipolar ventricular leads were used in greater than or eq ual to 50% of cases. In 6 of 14 countries, there was > 15% use of unipolar atrial leads. Nine of 13 countries frequently used atrial active-fixation l eads. For the 1997 survey, ICD data were obtained from 16 countries. The fe tal number of ICDs per million population was a median value of 14. Initial ICD implants per million population was 11. Only 3 of 16 countries implant ed a total of 30 or more ICDs per million population. Pacing and ICD practi ces were dependent on the availability of medical and technical resources a nd influenced by economic constraints inherent in health care administratio n and insurance coverage patterns.