背景：心脏可植入电子设备（CIED）已成为心脏病学日常临床实践中不可或缺的一部分。CIED植入的适应症基于欧洲心律协会（EHRA）的指南。然而，欧洲的CIED植入数量存在相当大的差异。我们假设与各自卫生系统相关的报销可能会影响植入行为。
方法：根据2017年EHRA白皮书，收集了CIED植入数据以及社会经济关键数据，特别是国内生产总值（GDP）和用于医疗保健的国内生产总值份额。起搏器的植入编号,对植入式心律转复除颤器和心脏再同步治疗以及全部进行了评估，与医疗保健支出进行比较，并使用热图进行可视化。
结果：每10万居民的植入总数从196.53（德国）到2.81（科索沃）不等。较高的植入数量与较高的GDP（r=0.456，p0.002）和较高的卫生支出（r=0.586，p<0.001）中度相关。每个居民的年度财政资源也有波动，从9476美元(瑞士)到140美元(乌克兰)不等；然而，有一些国家有很高的财政能力，如瑞士或斯堪的纳维亚国家，显示植入率显着降低。
结论：欧洲的CIED种植有相当大的差异。这些似乎部分原因是欧洲内部的社会经济差异。此外，各自的薪酬制度可能会产生潜在影响。
BACKGROUND: Cardiac implantable electronic devices (CIED) have become an indispensable part in everyday clinical practice in cardiology. The indications for CIED implantation are based on the
guidelines of the European Heart Rhythm Association (EHRA). Nevertheless, numbers of CIED implantations in Europe are subject to considerable differences. We hypothesized that reimbursements linked to the respective health systems may influence implantation behavior.
METHODS: Based on the EHRA White Book 2017, CIED implantation data as well as socioeconomic key figures were collected, in particular gross domestic product (
GDP) and share of gross domestic product spent on healthcare. Implantation numbers for pacemakers, implantable cardioverter defibrillators and cardiac resynchronization treatment as well as all in total were assessed, compared with the health care expenditures and visualized using heat maps.
RESULTS: Total implantation numbers per 100,000 inhabitants varied from 196.53 (Germany) to 2.81 (Kosovo). Higher implantation numbers correlated moderately with a higher
GDP (r = 0.456, p 0.002) and higher health expenditure (r = 0.586, p < 0.001). The annual financial resources per inhabitant were also subject to fluctuations ranging from 9476 $ (Switzerland) to 140 $ (Ukraine); however, there were countries with high financial means, such as Switzerland or Scandinavian countries, which showed significantly lower implantation rates.
CONCLUSIONS: There were considerable differences in CIED implantations in Europe. These seem to be explained in part by socioeconomic disparities within Europe. Also, a potential influence by the respective remuneration system is likely.
