World Surveys of Cardiac Pacing and Cardioverter Defibrillators: Current State and Future Plans Prof Harry G Mond Department of Epidemiology & Preventive Medicine, Monash University. Cardiology Department, Royal Melbourne Hospital, Melbourne, Australia. Dr Graeme Sloman Cardiologist, Victorian Heart Centre, Epworth Hospital and Cardiology Department, Royal Melbourne Hospital, Melbourne, Australia. November 2005

History of Pacing and Implantable Defibrillators 1972 Groningen 1975 Tokyo 1978 Montreal 1981 Vienna 1985 Jerusalem 1989 Washington DC 1993 Buenos Aires 1997 Berlin 2001 Hong Kong ICDs since 1993

Paul Zoll

Zoll’s External Pacemaker

Seymour Furman -developed in USA

Aubrey Leatham -developed in Britain

Victor Parsonnet Isotope power source longevity

History First World Survey was presented at the 4th International Symposium on Cardiac Pacing in Groningen Holland, April 1973 European pacemaker registry begun in countries participated in the 2001 survey

ICPES – International Cardiac Pacing and Electrophysiology Society ICPES was keen to support and continue world surveys Board member appointed to coordinate No BudgetNo Budget Survey presented at Hong Kong Symposium in 2003, was compared with Berlin survey (1999)

Major Deficiency in Records Change in indications for units Pacing and defib programs Alterations in hardware usage

Countries Involved USA — unique survey Asian Pacific Middle East Africa Canada Central America South America Europe

Countries Involved USA — unique survey Asian Pacific Middle East Africa Canada Central America South America Europe …similar to European survey

Alternative Method – European Type Survey Would need good support –In the USA, 250,000 units/year Would depend on enthusiastic country coordinators –Asian Pacific Region with 19 countries at time of 2001 survey

Patient Precautions Cooperation with pacing equipment companies Security of information very important Limitations on clinical information Difficulties: –Indications for first implants –Age –Gender Useful mainly to note trends, changes Accuracy depends on cooperation of ALL pacemaker companies

Countries Involved Presented in Hong Kong February 2003 for the first time.

European Pacemaker (ICD) Registry

Mean Annual ICD Implant Rate

Future: 13 th World Congress, Rome 2007 World survey for 2005 completed BUT No organisation to coordinate and check Needs ongoing organisation and enthusiastic young cardiologists ? Follow the European example