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.