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Europace 2009 11(10):1308-1312; doi:10.1093/europace/eup264
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

ICD

Inequity of access to implantable cardioverter defibrillator therapy in England: possible causes of geographical variation in implantation rates

Janet M. McComb1,*, Christopher J. Plummer1, Morag W. Cunningham2 and David Cunningham2

1 Department of Cardiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK; 2 Central Cardiac Audit Database, NHS Information Centre, UK

Aims: There is marked geographical variation in implantable cardioverter defibrillator (ICD) implantation rates in England. This study examined factors which might explain this variation.

Methods and results: Detailed data relating to 1510 patients who received an implanted defibrillator and who were reported to a national pacemaker and implantable defibrillator registry in 2002 were examined and correlated with factors which have been suggested as affecting ICD implantation. None of the factors examined, which included factors related both to the need for ICD implantation and service provision, in addition to socio-economic deprivation, was found to correlate with regional ICD implantation rates.

Conclusion: There appears to have been no systematic planning of ICD services. Whether this has led to the marked regional variation and in inequity of service provision is not clear.

Key Words: Implantable cardioverter defibrillator, Geographical variation, Inequity

* Corresponding author. Tel: +44 191 2137543, Fax: +44 191 2231400, Email: janet.mccomb{at}nuth.nhs.uk

Manuscript submitted 30 April 2009. Accepted after revision 21 August 2009.


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