[Permanent cardiac pacing in Italy to-day (author's transl)]

The current status of cardiac pacing in Italy is outlined by the following figures: 121 hospitals implant over 10,000 pacemakers each year. Of this number 69% are new implants which raises the incidence of new treated cases to 111 per million population, with the highest peach (197) in Tuscany. This figure was only 61 in 1973. At elsewhere, the dominant age group is the 7th decade; the prime indication for pacing is the symptomatic patient with a-v block (62% of all cases), the next most common one being chronic fascicular block (11%) and sick sinus syndrome (10%). The transvenous route is utilized in 98.3% of cases. The pacemaker of choice is the R-inhibited units; fixed rate units are used in only 4% of cases and units with conventional mercury battery cells in 66%, in favour of pacers with longer energy sources (e.g. lithium). Fifteen companies are supplying pacemakers in Italy and four of them are local manufacturers. An estimate 18,000 patients are being paced throughout the country to-day. Their density is highest in the region Friuli-Venezia Giulia (948 per million population). Follow-up of patients as a whole is not satisfactory being adequate only in about 50% of hospitals; telephone monitoring is available but in a few locations. The average cost of permanent pacing in Italy is the equivalent of 2.50 U.S. dollars per day.