Arrhythmia care in ESC member countries: the 2025 ESC-EHRA atlas on heart rhythm disorders
- PMID: 40697128
- PMCID: PMC12284390
- DOI: 10.1093/europace/euaf124
Arrhythmia care in ESC member countries: the 2025 ESC-EHRA atlas on heart rhythm disorders
Abstract
The ESC-EHRA Atlas on Heart Rhythm Disorders was developed to comprehensively map arrhythmia care across the European Society of Cardiology (ESC) member countries. A survey of National Cardiac Societies, Working Groups, and other EHRA partners in ESC member countries was conducted to gather data from 2023 or the most recently available year on arrhythmia care organization and delivery. In total, 51 ESC member countries actively participated in the study, with a survey completeness rate of 91%. The median number of hospitals performing EP or CIED procedures was 3.3 per million people. The annual median numbers of ablation procedures for heart rhythm disorders, atrial fibrillation, and supraventricular tachycardia per million people were 432, 151, and 136, respectively. The annual median numbers of pacemakers, implantable cardioverter-defibrillators (ICD), and cardiac resynchronization therapy cardioverter-defibrillator (CRT-D) implantations per million people were 739, 195, and 54, respectively. The median number of hospitals performing remote monitoring of CIEDs per million people was 0.5, though this service was unavailable in 15 countries. Two main universal issues emerged among the obstacles to guideline implementation: a lack of heart rhythm allied professionals and general dissatisfaction with the country's reimbursement system. The first edition of the ESC-EHRA Atlas presents up-to-date information on arrhythmia care organization and delivery among ESC member countries and highlights significant discrepancies in patients' access to ESC-guideline-recommended therapies.
Keywords: Ablation; Arrhythmia; Cardiac pacemakers; European Society of Cardiology; Health economics; Health infrastructure; Implantable cardiac defibrillators; Reimbursement; Statistics.
© The European Society of Cardiology 2025.
Conflict of interest statement
Conflict of interest: none declared.
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References
-
- Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomström-Lundqvist C et al. 2019 ESC guidelines for the management of patients with supraventricular tachycardia. The task force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J 2020;41:655–720. - PubMed
-
- Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM et al. 2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J 2021;42:3427–520. - PubMed
-
- Tzeis S, Gerstenfeld EP, Kalman J, Saad EB, Sepehri Shamloo A, Andrade JG et al. 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace 2024;26:euae043.
-
- Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns H et al. 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2024;45:3314–414. - PubMed
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