European report tracks lead extractions from 46 countries

The European Heart Rhythm Association (EHRA) added lead extractions to its annual compendium on arrhythmia treatments. The EHRA White Book was released online June 23 on the European Society of Cardiology (ESC) website in conjunction with the launch of EHRA EUROPACE 2013 in Athens.

EHRA President Angelo Auricchio, MD, PhD, and other EHRA representatives wrote that that goal of the publication is to improve the care of European patients with cardiac arrhythmias. “The EHRA White Book is a platform to monitor the yearly status of treatment of arrhythmia in ESC countries as well as to assess its dynamics and progressive harmonization in access to healthcare for arrhythmia treatment over the years,” according to the preface.

The 540-page report, which has been published annually since 2008, tracks the status of arrhythmia treatments in the 55 ESC member countries with a comparison to the previous year. Forty-six countries participated this year.  For each country it provides a section on statistics, a country profile, the healthcare system, education, pacemakers, cardiac resynchronization therapy (CRT) devices, implantable cardiac-defibrillators (ICDs), loop recorders, device-specific information, lead extractions, interventional electrophysiology, and guidelines.  

Countries participate voluntarily and most provide data collected through national databases. The authors noted that some countries still lack registries, though.

Lead extractions were added for the 2013 edition in keeping with practice trends. "This is an area of increasing interest because device therapy has now been provided for many years,” said Fernando Arribas, MD, EHRA White Book coordinator, in a release. “Device systems depend on the function of the leads which become [less reliable] as they get older and should be replaced. This is a growing problem because lead extraction has a significant morbidity and mortality all over the world."

According to the report, France far outpaced other countries for lead extractions in 2012, at 2,000. Germany reported 800 and Poland 520.  Iceland, Cyprus, Montenegro, Malta and Armenia had none on record.

Germany topped the list for procedures in many categories. For instance:

• Pacemaker implantations: 106,567;
• CRT implantations: 17,949;
• ICD implantations: 26,536; and
• Ablations, 38,000.

The EHRA will unveil a supplement to the report during the ESC Congress that will analyze data from 2008 to 2012. The event is scheduled for Aug. 31 through Sept. 4 in Amsterdam.

“The analysis will show how access to treatment has changed over time in individual countries,” Arribas said. “It will also allow countries to benchmark their results with other countries, and provide a picture of where inequalities remain in access to arrhythmias care in Europe.”

The EHRA White Book is available here.