Medical Device Daily s

Implantable cardioverter defibrillator (ICD) use gained increasing acceptance in Europe since 2004, jumping 75% from 80 device therapy procedures per one million people to 140 per million in 2008, according to a study published in the European Journal of Heart Failure.

Yet more advanced cardiac resynchronization therapy (CRT) pacemakers, used in combination with an ICD to correct dyssynchrony and prevent sudden cardiac death, recorded a 115% increase from 46 per million in 2004 to 99 per million in 2008.

The combined CRT/ICD therapy is now being used in Europe "on a large scale, increasingly being used as an adjunct to traditional drug treatment," according to the report

A study presented at this year's European Society of Cardiology Congress in Barcelona found that CRT combined with ICD decreased the risk of heart failure events even in relatively asymptomatic patients with a 34% reduction in the risk of all-cause mortality or heart failure.

The authors of the journal article note reports have described these two devices as a revolution in heart failure with one significant study cited in the most recent guidelines on heart failure suggesting implantation of an ICD was associated with a 23% reduction in all-cause mortality.

Led by Dirk Van Veldhuisen, MD, with the CardioVascular Centre at the University Medical Center Groningen (Groningen, the Netherlands), the investigators for the published article "Implementation Of Device Therapy for Patients with Heart Failure in Europe" studied ICD/CRT use in 15 European countries.

Any healthcare statistic citing an average for Europe must quickly be qualified as the so-called unified market is an amalgam of countries with independent medical societies issuing guidelines and single-payer systems with markedly different rules for reimbursement.

The study found highest rate of ICD implants was in Germany with 264 per million in 2008, followed by Denmark and the Netherlands. The lowest use of implants was recorded in Spain with 63 per million, Portugal with 68 per million and the UK with 74 per million.

The authors suggest there is an underuse of cardiac therapy devices in many of the countries surveyed citing another study that found "a big gap between the number of patients who fit the criteria for ICD implantation and the number who actually get such a device."

Based on a calculation of heart failure prevalence between 2% and 3% for the general population, the investigators estimate that around half of these patients potentially could present with an indication for an ICD, an astounding 10,000 per million population.

They note current data suggest that even where ICD/CRT usage is highest at 250 per million population, just 2.5% of those thought eligible are actually receiving an ICD today.

Suggesting that cost and different healthcare systems may explain some of the discrepancies in usage, author van Veldhuisen said, "we still have no clear cost-benefit analysis of more widespread use."

"Certainly, implantable devices are expensive, and, if we follow the guidelines, the cost implications will be substantial," he added.

Heart failure is by far the single biggest reason for acute hospital admission, according to the authors.

Almost 30 million people in Europe experience heart failure and the rate of incidence is still increasing as more cases are being identified, more people are living to an old age, and more are surviving a heart attack but with damage to the heart muscle, they note.

Other countries reporting data for the study that ranked between the highest usage and the lowest included Austria, Belgium, Finland, France, Ireland, Italy, Norway, Sweden, and Switzerland.

Sectra gets new Spanish distribution partner

Sectra (Link ping, Sweden) has signed a partnership agreement with the Spanish company Fundación Garc a Mu oz. Founded in 1920, Fundación Garc a Mu oz (FGM) is a supplier of medical equipment and has an extensive customer base in both the private and public healthcare sectors in Spain.

Through this partnership, FGM has become a distributor of complete system for digital mammography including Sectra MicroDose Mammography and breast imaging PACS (system for handling digital radiology images).

"Fundación Garc a Mu oz is a highly reputed company, and this partnership significantly strengthens Sectra's sales force in the large Spanish healthcare market," says Jesper S derqvist, president of Sectra's mammography operations.

"Spain has a national screening program and the demand for efficient digital mammography systems is growing," says Francisco Garc a Montagud, managing director of Fundación Garc a Mu oz. "With Sectra MicroDose Mammography, we can offer a unique high-volume screening solution with less than 50% of the dose level of other systems in the market without any compromise in image quality."

Sectra develops IT-systems and products for radiology, mammography and orthopedic departments. More than 1,000 hospitals worldwide use the system daily, together performing over 50 million radiology examinations annually. In Scandinavia, Sectra is the market leader with more than 50% of all film-free installations. Outside Scandinavia, Sectra's system is installed at customers in North America and most major countries in Europe and the Far East.