Arrhythmias & electrophysiologyCross-sectional study
Access to cardiac implantable electronic device therapy in the European Society of Cardiology EuroAsia region: a comparative analysis of implantation activity, infrastructure, and health financing
- Standardized European Society of Cardiology (ESC) EuroAsia Task Force (TF) survey
- National-level aggregated data
- contextualized using European Heart Rhythm Association Atlas indicators and World Bank/World Health Organization Health Expenditure Data
Authors' conclusion
Cardiac implantable electronic device implantation activity in the ESC EuroAsia region follows a clear complexity gradient (PM > ICD > CRT), indicating that access to advanced device therapy is primarily determined by system capacity rather than guideline awareness alone. Strengthening predictable reimbursement pathways, structured referral networks, workforce development, and national registries may reduce inequities and narrow the evidence-practice gap in sudden cardiac death prevention and heart failure management.
Study context
- Population
- ESC EuroAsia Task Force countries: Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, and Uzbekistan
- Exposure
- Implantation rates per million population were compared across Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, and Uzbekistan
Main finding
As reported in the abstract
Moderate variability
21-333 per million
Observational data: associations, not effects.
Further findings
ICD implantation rate
- Pronounced disparities
- 0.1-172 per million
Cardiac resynchronization therapy (CRT) implantation rate
- Pronounced disparities
- 1-135 per million
ICD and CRT implantation by implanting centre density and electrophysiology workforce
- Countries with higher density of implanting centres and greater electrophysiology workforce availability-most notably Georgia-had substantially higher per capita ICD and CRT implantation rates
Health expenditure and financing structure vs ICD and CRT implantation rates
- Moderate positive correlations between national health expenditure (%gross domestic product) and ICD and CRT implantation rates
- Financing structure (out-of-pocket vs. government share) showed no consistent association
- Exploratory analyses
Original publication
Summarised from the published abstract; every number is checked against it