The world survey of cardiac pacing and cardioverter-defibrillators: lessons learnt

A world-wide survey of cardiac pacing and implantable cardioverter-defibrillator (ICD) practices is held each 4 years. For the most recent survey held in 2001, 50 countries, 22 from Europe, 16 from the Asia Pacific region, 9 from the Americas and 3 from the Middle East and Africa participated. This was the first survey, where all countries completed a similar format allowing comparisons between countries. The European contribution came from the expanding European pacemaker registry. For countries outside Europe, the survey was based on a questionnaire completed by selected coordinators and conducted predominantly from hospital implants. In some large implanting countries such as the United States of America (USA) and Australia, the surveys were conducted using the sales figures of pacemaker and ICD companies. The major criticism of this method is the limited clinical information obtained. An alternative system would be an ongoing pacemaker and ICD registry in each country similar to the European model, which in the USA would be an expensive and logistical nightmare to organise and administer. With smaller implanting countries, the current system of a dedicated coordinator to conduct the hospital survey works well although there is still much recruiting work to do in Central America, the Middle East, Africa and to a lesser extent, South America.