National Registry on Cardiac Electrophysiology--2006

Clinical electrophysiology is one of the areas of cardiology that has seen most growth in Portugal, particularly in interventional cardiology, which includes ablation of arrhythmias and prevention of sudden cardiac death. The annual publication of a national registry enables us to assess qualitative and quantitative progress, compare our results with international data, assess the centers' training capabilities and inform health authorities of the activities and needs of the sector. The authors analyze the number and type of procedures performed during 2006 based on a survey sent to 19 national centers (15 public and 4 private) that performed diagnostic and interventional electrophysiology (15 centers) and/or implanted cardioverter-defibrillators (ICDs) (19 centers) in that year. The number of electrophysiology centers remained unchanged from 2005, but four new centers began implanting ICDs in 2006. In the year under review, 1805 electrophysiological studies were performed, 75.3% of which were followed by ablation therapy, a total of 1360 ablation procedures (a 22.3% increase over the previous year). Accessory pathways were the main indication for ablation (32%), followed by atrial flutter (25%), atrioventricular nodal reentrant tachycardia (23%), atrial fibrillation (10%), ventricular tachycardia (5%), atrial tachycardia (3%) and atrioventricular junction ablation (2%). In 2006, a total of 738 ICD devices were implanted, of which 64 were battery replacements and 674 were first implantations, with the following distribution: 346 single chamber (51.3%), 98 dual chamber (14.5%) and 230 integrated in ventricular resynchronization systems (34.1%). These figures reflect a lower growth rate than that of 2005, even though in 2006 first implantations rose from 54.7 to 67.4 devices per million population. The ICD implantation rate in Portugal is still far below the European average, which means there is a continuing need to raise awareness of this therapeutic option among the Portuguese medical community. With regard to the training capabilities currently available in Portugal, only 5 centers (all public) had a sufficient level of activity to fulfill the requirements stipulated for the subspecialty of cardiac electrophysiology. As for implantation of ICDs, 12 centers implanted more than 10 units, the minimum annual curricular limit for this subspecialty.