Spain and Britain use fewer heart devices

Europe's use of implantable heart rhythm devices has doubled in the past five years but some countries - notably Spain and Britain - lag well behind, suggesting patients there aren't getting treatment recommended by a major cardiology group.

Researchers said on Monday an analysis of 15 European countries showed a wide variation in uptake of the devices.

Implantable defibrillators detect abnormal rhythms and deliver a life-saving shock to restore a regular heartbeat.

They are recommended for patients with heart failure under European Society of Cardiology guidelines - but they cost tens of thousands of dollars each, and medical experts continue to debate their cost-effectiveness.

Dirk van Veldhuisen from the University of Groningen in the Netherlands, lead author of the latest study, said cost and different healthcare systems probably explained some of the discrepancies in usage across Europe.

"While some studies have found an added benefit from device therapy in heart failure, others have not - and we still have no clear cost-benefit analysis of their more widespread use," he said.

"Certainly, implantable devices are expensive, and, if we follow the guidelines, the cost implications will be substantial."

Writing in the European Journal of Heart Failure, his team said the use of implantable cardioverter-defibrillators (ICDs) across the population had increased to 140 per million in 2008 from 80 in 2004.

The highest rate of ICD implants in 2008 was in Germany at 264 per million, followed by Denmark and the Netherlands. But uptake was sharply lower in Spain at just 63 per million and Britain at 74.

The use of cardiac resynchronisation therapy (CRT), an advanced kind of pacemaker, has also increased to 99 from 46 per million across Europe since 2004, mainly due to increasing use of devices combining CRT and ICD treatment.

Nearly 22 million people worldwide suffer from heart failure, a chronic condition in which the heart struggles to pump blood, making them six to nine times more likely than others to suffer sudden cardiac death due to heart rhythm problems.

SOURCE: European Journal of Heart Failure