Atlas of invasive treatment for cardiac arrhythmias in Ukraine in 2018

Main Article Content

O. S. Sychov
A. O. Borodai

Abstract

The aim of the analysis was to provide comprehensive data on invasive therapies of cardiac arrhythmias in Ukraine in 2018. Association of Arrhythmologists of Ukraine has been collecting data on invasive cardiac arrhythmia therapies since 2010. In 2019, data for the survey were provided by 39 centers from all regions of Ukraine, with the exception of the temporarily occupied territory of the Autonomous Republic of Crimea, as well as a part of armed conflict zone in the east of Ukraine. In this analysis, we present updated data based on demographics and population statistics. In 2018 a total of 9597 procedures were performed, which is 824 (9.4 %) more compared to 2017, and has been the largest number since 2010. In total, 6265 pacemakers were implanted, which is 472 (8.1 %) more than in 2017. 54.8 % of them were dual chamber devices. The number of replacements for pacemakers decreased to 782, which is 143 (15.5 %) fewer than in 2017. In 2018, 98 CPT devices were implanted, which was 20 (24 %) more compared to 2017. Simultaneously, the number of CPT-D implantations grew by 24 (92.3 %) and equaled to 50. The number of defibrillator cardioverter implants increased to 166, which is 95 (133.8 %) more than in 2017. In 2018 a total of 2914 radiofrequency ablations were performed, which is 190 (7.0 %) more than in 2017. A total of 861 ablations of atrial fibrillation were performed, which is 127 (17.3 %) more compared with 2017. At the same time, the number of ablations in ventricular tachycardia with complex substrate decreased by 1 (2.7 %), totaling 36 procedures. A total of 96 extractions of electrodes were performed, which is 20 (26.3 %) more than in 2017. In addition, in 2018, 5 ECG recorders were implanted and 3 left atrial appendage closures were performed. Despite the positive dynamics, in the total number of procedures, primarily due to artificial rhythm drivers, there remains a significant heterogeneity in the availability of invasive methods of treatment across different regions of Ukraine. For example, ablation is only available in 7 regions, and atrial fibrillation ablations are performed only in 4 regions of the country. More than 10 defibrillator cardioverters have been implanted in only five centers in four regions of Ukraine. Despite the steady positive dynamics in Ukraine, the number of procedures performed is much lower than in other countries, members of ESC (European Society of Cardiology).
Conclusions. There has been a significant increase in the number of invasive interventions for cardiac arrhythmias in Ukraine. In 2018, their number was the highest since 2010. At the same time, heterogeneity in access to them continues to exist across different regions of Ukraine, so further efforts are needed to improve the situation.

Article Details

Keywords:

invasive treatment, cardiac arrhythmias, sudden death

References

State Statistics Service of Ukraine / http://www.ukrstat.gov.ua/

Ministry of Finance of Ukraine https://index.minfin.com.ua/ua/finance/budget/gov/expense/2018

International Monetary Fund

https://www.imf.org/external/pubs/ft/weo/2018/02/weodata/weorept.aspx?sy=2016&ey=2023&scsm=1&ssd=1&sort=country&ds=.&br=1&pr1.x=26&pr1.y=11&c=926&s=NGDP&grp=0&a=

Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P; Authors/Task Force Members; Document Reviewers. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC)Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESCEndorsed by the European Stroke Organisation (ESO). Europace. 2016 Aug 27. pii: euw295 https://doi.org/10.1093/ejcts/ezw313

Kusumoto FM., Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD/ 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay Journal of the American College of Cardiology Nov 2018, 25701; https://doi.org/10.1016/j.jacc.2018.10.044

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano JMS, Ruilope LM, Ruschitzka F, Rutten FH, Meer P, ESC Scientific Document Group; 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, 2016 European Heart Journal; 37, Issue 27, 14 July, Pages 2129–2200 https://doi.org/10.1093/eurheartj/ehw128

Priori S, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål T, Spaulding C, Veldhuisen D. ESC Scientific Document Group; 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), European Heart Journal 2015;36, Issue 41, 1 November:2793–2867 https://doi.org/10.1016/j.rec.2016.01.001

Raatikainen PMJ, Arnar DO, Merkely B, Nielsen JC, Hindricks G, Heidbuchel H, Camm J. A Decade of Information on the Use of Cardiac Implantable Electronic Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries: 2017 Report from the European Heart Rhythm Association, EP Europace, August 2017;19(suppl_2), 1:ii1–ii905 https://doi.org/10.1093/europace/eux258

Most read articles by the same author(s)