 |
|
Big disparities in the treatment of arrhythmias across Europe
June 22, 2009The latest statistics regarding the use of pacemakers and implantable cardiac devices in Europe was presented on Sunday 21 June, at EUROPACE 2009, the meeting of the European Heart Rhythm Association (EHRA)[1] which takes place in Berlin, Germany from 21 to 24 June.
These facts and figures, including the current status of healthcare systems across the continent, were included in the EHRA White Book[2].
"This document is intended to be the starting point in a move towards a homogeneous way of looking at data, resources, physicians, etc., across Europe. Comparison among the countries belonging to the European Society of Cardiology (ESC)[3], should help to standardise health resources by promoting knowledge of the status and bringing it to the attention of all public authorities" explained Christian Wolpert, Chairman of the National Societies who contributed the information gathered in the White Book.
"One of the roles of a European Association like the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), is to promote equal access to therapy for all patients across Europe. To do so, the first step is to compile data on the current situation in various ESC membership countries, compare them, and propose actions to move towards harmonization. The current leadership of EHRA agreed on the importance of obtaining as much current information as possible concerning the situation of the practice of electrophysiology in Europe" stressed Wolpert.
Under the leadership of Professors Christian Wolpert from Germany, Panos Vardas from Greece and Josep Brugada from Spain, a group worked to collect the most recent figures. To ensure up to date data, Presidents of the different Working Groups and National Societies were contacted and asked not only to provide data, but also to verify and authorize all the information that became available through various sources.
Wolpert declared that this data is also the point of comparison for the future: " By knowing where we are today, we will be able to benchmark in the future and see how diverse countries evolve. This means that this book must be an ongoing process, with updated information, new and additional data, and the inclusion of information from those countries that have not yet been able to collect and transmit their records."
Explaining the data, Prof Wolpert highlighted certain trends, such as the fact that "more and more, cardiologists represent the majority of implanters while surgeons are decreasingly active in these procedures."
There is a disparate coverage of diseases and treatments within the European Union and the European Society of Cardiology member countries outside of the EU. Some of the countries have no reimbursement e.g. for ICD or pacemaker therapy and the penetration of catheter ablation of atrial fibrillation is very different. Data shows big differences across ESC member countries in:
* Guideline implementation.
* The number of trained physicians and specialised centres
* The number of implantations which seems to depend not only on reimbursement and financial resources, but also to be a function of the number of centres and physicians dedicated to electrophysiology and implantation of devices.
* The numbers of ICD implanting centres range from less than 1 to 6.87 per million citizens.
* Pacemaker therapy is performed in the range of 88 to a maximum of around 1200/ million inhabitants.
* ICD implant rates including CRT-D devices range from approx. 2.5 to 354 per million inhabitants. The data shows an increase for a subset of 16 western and northern European countries around 15% from 2006 to 2007.
* Regarding a potentially different medical consensus in specific countries the use of biventricular pacemakers vs. biventricular ICDs shows a 8:1 ratio at the highest down to 1:1.2 ratio as the lowest.
* In the field of invasive electrophysiology and catheter ablation for supraventricular and ventricular arrhythmias the number of centres available is variable ranging from less than 0.2 to more than 3 centres/ million. The total number of catheter ablations is increasing and reaches a maximum of more than 200/ million in approx. half of the countries. However, there is a strong discrepancy comparing all 35 countries, displaying a wide range from less than 20 to more than 450/ million.
* The same is true for catheter ablation of atrial fibrillation which varies tremendously, linked to reimbursement policies but also to different approaches in the various EP societies.
"As an example, Germany, hosting the EUROPACE meeting this year, has one of the highest implant rates for ICD's in Europe with a total of 1037 centres which implant pacemakers; 200 centres implanting CRT resynchronisation devices and a total of 360 ICD implanting institutions" highlights Prof Wolpert.
"Within the Non-EU ESC member countries, there has been a steady increase of therapy availability and disease coverage, however, there are still many countries that struggle with reimbursement, trained personnel and technical support, which requires a strong effort and leaves much space for improvement. It is the task and the intention of EHRA to support any initiative to improve steadily the situation for these countries in order to reduce the disparities".
The first EHRA White Book was published in 2008 containing information for 2006 and 2007 from 35 of the 51 ESC member countries from all sites of Europe and parts of the Middle East. The book was made fully available to the public in an electronic version and within short time it became one of the most popular downloads in the EHRA website.
"We hope that this book will be useful to all electrophysiologists and health care providers in Europe and will initiate an era of evolution towards a more unified Europe in terms of equal access to therapy for all patients, regardless of their country origin", concluded Prof Wolpert.
###
NOTES:
1 EHRA, the European Heart Rhythm Association, aims to serve as the leading organisation in the field of arrhythmias and electrophysiology in Europe, and to attract physicians from all of Europe and beyond to foster the development of this area of expertise. EHRA is a registered branch of the European Society of Cardiology (ESC). EHRA is based in Sophia Antipolis, France. Visit us at www.escardio.org/EHRA
2 The European Society of Cardiology (ESC) represents more than 50,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe. Visit us at www.escardio.org
3 Full version of the white book available on: http://www.escardio.org/communities/EHRA/publications/Pages/white-book-project.aspx
European Society of Cardiology
"One of the roles of a European Association like the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), is to promote equal access to therapy for all patients across Europe. To do so, the first step is to compile data on the current situation in various ESC membership countries, compare them, and propose actions to move towards harmonization. The current leadership of EHRA agreed on the importance of obtaining as much current information as possible concerning the situation of the practice of electrophysiology in Europe" stressed Wolpert.
Under the leadership of Professors Christian Wolpert from Germany, Panos Vardas from Greece and Josep Brugada from Spain, a group worked to collect the most recent figures. To ensure up to date data, Presidents of the different Working Groups and National Societies were contacted and asked not only to provide data, but also to verify and authorize all the information that became available through various sources.
Wolpert declared that this data is also the point of comparison for the future: " By knowing where we are today, we will be able to benchmark in the future and see how diverse countries evolve. This means that this book must be an ongoing process, with updated information, new and additional data, and the inclusion of information from those countries that have not yet been able to collect and transmit their records."
Explaining the data, Prof Wolpert highlighted certain trends, such as the fact that "more and more, cardiologists represent the majority of implanters while surgeons are decreasingly active in these procedures."
There is a disparate coverage of diseases and treatments within the European Union and the European Society of Cardiology member countries outside of the EU. Some of the countries have no reimbursement e.g. for ICD or pacemaker therapy and the penetration of catheter ablation of atrial fibrillation is very different. Data shows big differences across ESC member countries in:
* Guideline implementation.
* The number of trained physicians and specialised centres
* The number of implantations which seems to depend not only on reimbursement and financial resources, but also to be a function of the number of centres and physicians dedicated to electrophysiology and implantation of devices.
* The numbers of ICD implanting centres range from less than 1 to 6.87 per million citizens.
* Pacemaker therapy is performed in the range of 88 to a maximum of around 1200/ million inhabitants.
* ICD implant rates including CRT-D devices range from approx. 2.5 to 354 per million inhabitants. The data shows an increase for a subset of 16 western and northern European countries around 15% from 2006 to 2007.
* Regarding a potentially different medical consensus in specific countries the use of biventricular pacemakers vs. biventricular ICDs shows a 8:1 ratio at the highest down to 1:1.2 ratio as the lowest.
* In the field of invasive electrophysiology and catheter ablation for supraventricular and ventricular arrhythmias the number of centres available is variable ranging from less than 0.2 to more than 3 centres/ million. The total number of catheter ablations is increasing and reaches a maximum of more than 200/ million in approx. half of the countries. However, there is a strong discrepancy comparing all 35 countries, displaying a wide range from less than 20 to more than 450/ million.
* The same is true for catheter ablation of atrial fibrillation which varies tremendously, linked to reimbursement policies but also to different approaches in the various EP societies.
"As an example, Germany, hosting the EUROPACE meeting this year, has one of the highest implant rates for ICD's in Europe with a total of 1037 centres which implant pacemakers; 200 centres implanting CRT resynchronisation devices and a total of 360 ICD implanting institutions" highlights Prof Wolpert.
"Within the Non-EU ESC member countries, there has been a steady increase of therapy availability and disease coverage, however, there are still many countries that struggle with reimbursement, trained personnel and technical support, which requires a strong effort and leaves much space for improvement. It is the task and the intention of EHRA to support any initiative to improve steadily the situation for these countries in order to reduce the disparities".
The first EHRA White Book was published in 2008 containing information for 2006 and 2007 from 35 of the 51 ESC member countries from all sites of Europe and parts of the Middle East. The book was made fully available to the public in an electronic version and within short time it became one of the most popular downloads in the EHRA website.
"We hope that this book will be useful to all electrophysiologists and health care providers in Europe and will initiate an era of evolution towards a more unified Europe in terms of equal access to therapy for all patients, regardless of their country origin", concluded Prof Wolpert.
###
NOTES:
1 EHRA, the European Heart Rhythm Association, aims to serve as the leading organisation in the field of arrhythmias and electrophysiology in Europe, and to attract physicians from all of Europe and beyond to foster the development of this area of expertise. EHRA is a registered branch of the European Society of Cardiology (ESC). EHRA is based in Sophia Antipolis, France. Visit us at www.escardio.org/EHRA
2 The European Society of Cardiology (ESC) represents more than 50,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe. Visit us at www.escardio.org
3 Full version of the white book available on: http://www.escardio.org/communities/EHRA/publications/Pages/white-book-project.aspx
European Society of Cardiology
Cardiology Current Events and Cardiology News RSSStudy suggests dentists can identify patients at risk for fatal cardiovascular event
A new study indicates dentists can play a potentially life-saving role in health care by identifying patients at risk of fatal heart attacks and referring them to physicians for further evaluation.
Experts unveil new CVD guidelines and position papers
Several new guidelines and position papers offering the most up to date information to ensure that clinicians practice evidence-based medicine were released at the Canadian Cardiovascular Congress 2009 this week.
Learning the risks for stroke - and taking action
With this theme in mind, the European Society of Cardiology (ESC) emphasises that most of the risks for stroke are also the major risks for coronary heart disease - and thus the object of the ESC's far-reaching prevention programme.
Canadian cardiology team clears the way for lifesaving breast cancer treatment
A team of Canadian cardiologists, in collaboration with oncologists, are playing an important role in the war against breast cancer Dr. Michael McDonald told the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
Survival after heart attack improves in younger women
In recent years, women, particularly younger women, experienced larger improvements in hospital mortality after myocardial infarction (MI) than men, according to a study published in the Oct. 26, 2009 issue of Archives of Internal Medicine.
Accelerated bone growth may be an indicator of hypertension in children
Children whose bones are "older" than their chronological age may be at an increased risk of hypertension, according to a study reported today (19 October) in Hypertension: Journal of the American Heart Association.
MedImmune to present data on RSV and influenza at 2009 AAP National Conference and Exhibition
MedImmune announced today it will present four abstracts at the American Academy of Pediatrics (AAP) 2009 National Conference & Exhibition that add to the company's growing body of research on the burden of respiratory syncytial virus (RSV) on children, as well as pediatric infectious disease prevention.
New mathematical model more accurately diagnoses acute heart failure in emergency rooms
Researchers at St. Michael's Hospital have developed the first mathematical model in cardiology and emergency medicine to more quickly and reliably diagnose acute heart failure (AHF) in emergency room patients.
Patients who received donated pacemakers survive without complications
Patients who received refurbished pacemakers donated from Detroit area funeral homes survived without complications from the devices, according to a case series reported by the University of Michigan Cardiovascular Center.
Designing drugs and their antidotes together improves patient care
Imagine a surgical patient on a blood-thinning drug who starts bleeding more than expected, and an antidote that works immediately - because the blood thinner and antidote were designed to work together.
More Cardiology Current Events and Cardiology News Articles
 |
Cardiology Essentials by Teresa Holler (Author) Cardiology Essentials offers practical advice from a seasoned cardiology physician assistant on how to be an efficient, competent member of the cardiology team. This handbook will provide the basics of how to care for the most common cardiac conditions encountered in clinical practice. Oftentimes, the supervising physician is inaccessible during a medical crisis. This handbook supplies the practicing PA/NP with the critical information and confidence they need to handle such crises when they arise. Written in an easy-to-read format, this book allows the PA/NP or student to read the book and immediately feel at home in the world of cardiology. |
 |
Clinical Cardiology Made Ridiculously Simple (Edition 3 - 2009) by Michael A Chizner (Author) Completely revised and updated, this best selling book is a clear, concise, highly practical and enjoyable overview of all of clinically relevant cardiology: history, physical, ECG (ECG interpretation taught in just 40 pages), radiology, noninvasive and invasive diagnostic tests, and therapy (both pharmacologic and nonpharmacologic). This third edition includes interactive CD-ROM (Win/Mac) with heart sounds, ECG interpretation, chest x-rays, echocardiography and quiz. Numerous new illustrations, cartoons, and images are also included. For medical students, house officers, cardiac fellows, practicing physicians, nurses, and other health care professionals. |
 |
Practical Cardiology: Evaluation and Treatment of Common Cardiovascular Disorders by Ragavendra R Baliga (Editor), Kim A Eagle (Editor), William F Armstrong (Editor), David S Bach (Editor), Eric R Bates (Editor) Thoroughly updated to reflect current American College of Cardiology/American Heart Association guidelines, this concise yet comprehensive handbook presents practical information on the common cardiovascular problems that clinicians encounter daily. The book provides a user-friendly, authoritative guide to evaluation of common cardiovascular symptoms and evaluation and management of common cardiovascular conditions. Coverage also includes clinical challenges such as management of chronic anticoagulation, assessing and minimizing cardiac risk in noncardiac surgery, and management of the cardiac surgery patient. Numerous tables and algorithms help readers find information quickly and aid in clinical decision-making. |
 |
The Washington Manual® Cardiology Subspecialty Consult (Washington Manual Subspecialty Consult) by Washington University School of Medicine Department of Medicine (Editor), Phillip S Cuculich (Editor), Andrew M Kates (Editor), Katherine E Henderson (Editor), Thomas M De Fer (Editor) Prepared by residents, fellows, and attending physicians at the Washington University School of Medicine, this handbook is a practical quick-reference guide to the diagnosis and treatment of cardiovascular diseases. It covers both inpatient and outpatient management approaches with the same front-lines practicality as the world-famous Washington Manual of Medical Therapeutics. Chapters include mnemonics, easily remembered bullet-point lists, bold-faced clinical pearls, and easy-to-read figures. This thoroughly revised, updated Second Edition emphasizes current guidelines from the American Heart Association and American College of Cardiology. New chapters cover new cardiac imaging modalities, peripheral vascular diseases, and cardiovascular diseases in specific patient populations,... |
 |
Mayo Clinic Cardiology: Concise Textbook, Third Edition by Joseph G. Murphy (Editor) For busy clinicians, residents, and fellows continually challenged with a rapidly expanding body of cardiology information, this expertly conceived Third Edition of a best-selling textbook provides a contemporary succinct distillation of the current status of cardiovascular knowledge and disease. From specific diseases to particular signs, symptoms, and patient concerns, including pregnancy and heart disease and cardiac emergency, this easily readable textbook guides the reader through all the essential information required to skillfully approach professional board examinations and practice state-of-the-art clinical patient care. |
 |
CURRENT Diagnosis & Treatment in Cardiology, Third Edition (LANGE CURRENT Series) by Michael Crawford (Author) The latest clinical advances in cardiology at your fingertips! "This is useful as a quick reference, most suitable for physicians in training, medical students and midlevels dealing with cardiac patients. 3 Stars."--Doody's Review Service Presented in the easy-to-use CURRENT format, this book covers all the major disease entities and therapeutic challenges in cardiology. Concise, yet comprehensive, it is perfect for board review as well as for all aspects of heart disease care. Covers every important management issue in cardiology Includes special topics such as heart disease in pregnancy and the athlete's heart Consistent chapter template that includes diagnostic techniques, prevention strategies, treatment, and prognosis All... |
 |
Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, Single Volume (Heart Disease (Braunwald) (Single Vol)) by Peter Libby MD (Author), Robert O. Bonow MD (Author), Douglas L. Mann MD FACC (Author), Douglas P. Zipes MD (Author) Dr. Braunwald's masterwork returns ... bringing you the definitive guidance you need to overcome any challenge in clinical cardiology today, using the best approaches available! Hundreds of world authorities, many of them new to this edition, synthesize all of the recent developments that are revolutionizing practice - from the newest findings in molecular biology and genetics to the latest imaging modalities, interventional procedures, and medications. The expertise of the book's contributors, the scope of its coverage, and its richly illustrated, user-friendly format all make this the ultimate reference for the practicing cardiologist. Locate the answers you need fast, thanks to a user-friendly, full-color design, complete with more than 1,500 color illustrations.Glean clinically... |
 |
Little Black Book of Cardiology (Jones and Bartlett's Little Black Book Series) by John A. Sutherland (Author) Thoroughly revised and updated, the second edition of this pocket-sized handbook provides comprehensive, concise, evidence-based information on diagnosing and treating cardiac disorders. The Little Black Book of Cardiology is a convenient resource offering quick access to vital information and makes a great reference for solving pressing problems on the ward or in the clinic. |
 |
Concise Cardiology: An Evidence-Based Handbook by David V Daniels (Editor), Stanley G Rockson (Editor), Randall Vagelos (Editor) Written by residents, fellows in training, and experienced attending physicians, this pocket book presents an evidence-based clinical approach to cardiology in a concise quick-reference format. The book is designed for rapid point-of-care consultation and is ideal for residents, fellows, and practitioners who operate in a fast-paced environment. The comprehensive coverage ranges from preventive cardiology, to acute coronary syndromes, to electrophysiology, to cardiology consultation. Current AHA/ACC guidelines are combined with evidence-based findings and reviews of clinical trials. Each clinical problem is analyzed in detail to aid in diagnosis. Appendices cover central vascular access techniques and clinical pharmacology. |
 |
Cardiology: Expert Consult - Online and Print (Expert Consult Title: Online + Print) by Michael H. Crawford MD FACC (Author), John P. DiMarco MD PhD (Author), Walter J. Paulus MD PhD (Author) With your heavy case load, you can't afford to waste time searching for answers. Online and in print, Cardiology, 3rd Edition, by Drs. Crawford, DiMarco, and Paulus, offers you just the practical, problem-based guidance you need to quickly overcome any clinical challenge. 8 color-coded sections cover the 8 major clinical syndromes of cardiovascular disease-each section a virtual "mini textbook" on its topic! 40 new chapters keep you up to date with the latest advances in the field, while more than 2,000 lavish, high-quality illustrations, color photographs, tables, and ECGs capture clinical manifestations as they present in practice. Expert Consult functionality enables you to reference the complete contents from any location...and find the guidance you need in less time. It's current,... |
| © 2009 BrightSurf.com |