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Category Archive: Cardiac Rhythm Management

National Cardiac Rhythm Management Devices 2015/16 Annual Report now available

The 11th annual report for the National Cardiac Rhythm Management Devices Audit was published on 14th February 2017

The report presents the official record of CRM device procedures and quality issues related to the provision of CRM devices between 1st April 2015 and 31st March 2016.

The 2015/16 report shows a variation in implantation rates for pacemakers and defibrillators, nationally and in comparison to Europe. The report presents the official record of CRM devices procedures, quality issues related to the provision of CRM devices and recommendations based on these findings.

The report and press release are available to view and download from:

CRM Devices National Audit Report 2015-16 (pdf)

Press Release (pdf)

The National Audit of Cardiac Rhythm Management publishes new information in the 2014-15 devices annual report

A large number of patients at risk of sudden cardiac death are not being treated appropriately, according to the National Audit of Cardiac Rhythm Management Devices 10th annual report.

Despite recent NICE (National Institute for Health Care & Excellence) guidelines recommending the use of implantable cardioverter defibrillators (ICDs) in a wider range of patients, the figures for 2014/15 show that the UK implant rate is still half the European average, despite having risen since last year.

The report also shows that pacemaker implant rates remain static but also well below the European average. Meanwhile Cardiac resynchronization therapy (CRT) implants, an effective therapy that improves the heart’s ability to pump blood and oxygen to the body, continues to rise; the total rate of CRT implantation in the UK is now above the European average.

Most centres report very high rates of appropriate pacemaker type for sinus node disease, the sinus node is the heart’s natural pacemaker, and the overwhelming majority of pacemakers and complex devices are implanted in centres that do sufficient numbers to meet the recommended standard. However, a small proportion of procedures are reported from centres with extremely low implant rates.

The National Audit of Cardiac Rhythm Management audit details implants of pacemakers, defibrillators, and cardiac resynchronization therapy (CRT) in the UK.

The National Audit of Cardiac Rhythm Management is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and is led by the National Institute of Cardiovascular Outcomes Research (NICOR) working closely with the British Heart Rhythm Society (BHRS).

Dr Francis Murgatroyd, Chair of the British Heart Rhythm Society Audit Committee and Clinical Lead of the CRM Audit said:

“Pacemakers are implanted in patients to prevent the heart beating too slowly or stopping, which can cause blackouts.  Although the number of pacemakers implanted has increased by 25% over the last 12 years, in line with an ageing population, the UK remains somewhat below the European average for implants, suggesting that many patients that need pacemakers are not receiving them

The 2014-5 audit shows that the overwhelming majority of devices in the UK are implanted in centres that easily meet the BHRS standard.  However, a number of centres are either not reaching this standard or are not reporting all their procedures to the audit.  In future years the audit will identify both individual centres and individual implanters who are undertaking small procedure numbers and may not have sufficient ongoing experience to be safe and sustainable.”

The figures measure cardiac device implants in hospitals in England and Wales for the period April 2014 to March 2015. This is the second of these annual reports to present information by individual hospitals.

View or download the report

Any comments or queries to Anthony Bradley at NICOR:

Clinical Services Quality Measures: Consultation Launches Today

The overall objective of the NICOR cardiac audits is to provide information to enable those who receive, deliver and commission healthcare to measure and improve services.

Clinical Services Quality Measures are one of the ways we will provide this information in a timely manner and will allow ‘at-a-glance’ comparisons of similar services across the country. The work has been commissioned by NHS England, and the cardiac measures will initially focus on the treatment of patient with hearts attacks.

We are currently in the development phase and have identified a long list of measures. These measures will be used to measure a quality service and aim to answer the following questions:

Patients: Clinicians: Answered by:
 Was I given the best care?  Did I do the right things?  CSQM measures based on good practice criteria or standards.
 Has my health improved?  Am I helping to improve survival and reduce morbidity?  CSQM based on life mortality and morbidity rates.

We would like your help to ensure we have the right domains and indicators to answer these questions.

What are the measures?

The CSQM spreadsheet* provides a full list of measures that cover both STEMI and NSTEMI patients.

*If you have any problems accessing the spreadsheet file, please access this link

These are separated into two worksheets to reflect the different patient pathways for Heart attack patients:

1) Primary Percutaneous Coronary Intervention (pPCI) Centres (centres that treat over 20 patients per year)

2) Non primary PCI centres or centres performing less than 20 cases per year.

If you would like to provide feedback on both the pPCI and nonPCI centres you will need to complete both surveys:

  1. primary PCI CSQM survey
  2. non primary PCI CSQM survey.

We would very much appreciate whatever you are able to do, while recognising that you are busy and have many demands on your time. Your input is very valuable.

The consultation closes on July 31st 2016.

  • Further information  about the CSQM programme can be found on the NHS England website.
  • A summary and FAQs for the Cardiac Clinical Services Quality Measures is available here.

Ablation Report 2014

The 9th annual report of the National UK Cardiac Rhythm Management (CRM) Ablation Audit Report covers ablation for cardiac arrhythmias during the 2013/14 financial year, along with trends over preceding (calendar) years.

The report highlights a widespread variation in ablation rates per capita both within regions and through the UK. However, larger centres appear to perform more AF ablation procedures in proportion to other types of ablation.  When comparing with immediate Western European neighbours, ablation rates in the UK remain low and are below the average for ‘greater’ Europe.

The full report can be read by following the link given below:

More information about the audit can be found by following the link below:

CRM Audit Annual Report for 2013-14 Now Available

The 9th annual report of the National Audit of Cardiac Rhythm Management (CRM) Devices was published on 19 December 2014.

The report details the number of implants of heart pacemakers and other devices carried out by every hospital in England and Wales between April 2013 and March 2014. It is the first of these annual reports to present information at hospital level.

The report is available to view and download from:

Headlines from the report are:

Total UK implant rates have increased but remain below the European average.

There has been a steady increase in pacemaker implant rates across the UK in recent years, in line with an ageing population./

Cardiac resynchronization therapy (CRT) implant rates have continued to increase and approach or exceed national targets.

NICOR CRM Devices 2012 Annual Report

The 2012 annual report on devices from the Cardiac Rhythm Management National Audit has now been published. It is available to view and download from:

This report includes summary information by Local Area Team (LAT) – the data from 2010 and 2011 has been re-analysed by this new output area to allow serial comparison. Full reports by individual LAT will follow as soon as possible.

Headlines from the report are

· a striking rise in CRT device implants

· ICD and simple pacemaker implants show little change.

Any comments or queries to Morag Cunningham at NICOR:

morag.cunningham [at]