Regional variations in baseline characteristics of cardiac rhythm device recipients: The PANORAMA observational cohort study

Abstract

Background: The PANORAMA study was designed to collect concurrent data on subjects from different worldwide regions implanted with CRM devices.

Methods: In this prospective, multi-center study, we analyzed baseline data on 8586 subjects implanted with CRM devices with no additional selection criteria (66% pacemaker (IPG), 16% implantable cardiac defibrillators (ICD), 17% cardiac resynchronization therapy (CRT) and < 1% Internal Loop Recorder) from 156 hospitals across 6 geographical regions between 2005 and 2011.

Results: Regardless of the device implanted, subjects from the Middle East and India often had more diabetes than other regions. Eastern and Western Europe had higher rates of atrial fibrillation reported, and men were more likely to smoke than women (46% vs 11%, p < 0.001). Within the CRT cohort there was significant variation in the proportion of males receiving a device, ranging from 55% in India to 83% in Eastern Europe.

Conclusions: We provide comprehensive descriptive data on patients receiving CRM devices from a range of geographies that are not typically reported in literature. We found significant variations in clinical characteristics and implant practices. Long term follow-up data will help evaluate if these variations require adjustments to outcome expectations.

Keywords: AV, atrio-ventricular; Bradyarrhythmias; CRM, cardiac rhythm management; CRT, cardiac resynchronization therapy; Cardiac pacing; Cardiac resynchronization; DFT, defibrillation threshold testing; Defibrillators; Heart failure; ICD, implantable cardioverter-defibrillator; IPG, implantable pulse generator; Tachyarrhythmias.