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Updated: Jun 15, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Tracing the European course of cardiac resynchronization therapy from 2006 to 2008
Bela Merkely1, Attila Roka, Valentina Kutyifa
1Heart Centre, Semmelweis University, Varosmajor utca 68, Budapest H-1122, Hungary. merkely.bela@kardio.sote.hu
Insights
Cardiac resynchronization therapy (CRT) use varies significantly across Europe due to factors like reimbursement and national guidelines, not just GDP. Improving these can increase CRT availability for heart failure patients.
Area of Science:
- Cardiology
- Medical Technology
- Health Services Research
Background:
- Cardiac resynchronization therapy (CRT) is effective for severe heart failure with intraventricular dyssynchrony.
- High cost and implantation complexity can limit CRT adoption.
- The European Heart Rhythm Association (EHRA) aims to harmonize arrhythmia treatment across Europe.
Purpose of the Study:
- To analyze variations in CRT utilization across European countries.
- To identify factors influencing CRT adoption rates between 2006-2008.
Main Methods:
- Analysis of data from 41 European countries for the years 2006-2008.
- Utilized data from EHRA White Books, encompassing governmental, insurance, and professional society information.
- Examined correlations between CRT utilization and factors like reimbursement, national guidelines, and GDP.
Main Results:
- Significant differences observed in CRT implantation numbers and growth rates among countries.
- Local reimbursement policies and national guidelines strongly correlate with CRT utilization.
- High rates of conventional implantable cardioverter-defibrillator (ICD) implantations also linked to CRT use.
- GDP and overall healthcare spending showed less impact on CRT adoption.
Conclusions:
- CRT availability is influenced by specific healthcare policies and infrastructure, not solely economic factors.
- Targeting improvements in reimbursement and guideline development can enhance CRT accessibility.
- Addressing these factors is crucial for increasing underutilized CRT in certain European regions.
Abstract:
Cardiac resynchronization therapy (CRT) is a highly efficient treatment modality for patients with severe congestive heart failure and intraventricular dyssynchrony. However, the high individual cost and technical complexity of the implantation may limit its widespread utilization. The European Heart Rhythm Association (EHRA) launched a project to assess treatment of arrhythmias in all European Society of Cardiology member countries in order to have a platform for a progressive harmonization of arrhythmia treatment. As a result, two EHRA White Books have been published in 2008 and 2009 based on governmental, insurance, and professional society data. Our aim was to analyse the local differences in the utilization of CRT, based on these surveys. A total of 41 countries provided enough data to analyse years 2006-2008. Significant differences were found in the overall number of implantations and the growth rate between 2006 and 2008. Other contributing factors include local reimbursement of CRT, the existence of national guidelines, and a high number of conventional implantable cardioverter-defibrillator implantations, while GDP or healthcare spending has less effect. Focusing on improving these factors may increase the availability of CRT in countries where it is currently underutilized.
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