Ten year trends in cardiac implantable electronic devices in New
Zealand: a national data linkage study (ANZACS-QI 51).
Abstract
Introduction Implant rates for cardiac implantable electronic devices
(CIED), including permanent pacemakers (PPM) and implantable
cardioverter defibrillators (ICD), have increased globally in recent
decades. This is the first national study providing a contemporary
analysis of national CIED implant trends by sex-specific age groups over
an extended period. Methods Patient characteristics and device type were
identified for ten years (2009 to 2018) using procedure coding in the
National Minimum Datasets, which collects all New Zealand (NZ) public
hospital admissions. CIED implant rates represent implants/million
population. Results New PPM implant rates increased by 4.6%/year
(p<0.001), increasing in all age groups except patients
<40 years. Males received 60.1% of new PPM implants, with
higher implant rates across all age groups compared to females. The
annual increase in age-standardised implant rates was similar for males
and females (3.4% vs 3.0%, p=0.4). By 2018 the overall PPM implant
rate was 538/million. New ICD implant rates increased by 4.2%/year
(p<0.001), increasing in all age groups except patients
<40 and ≥80 years. Males received 78.1% of new ICD implants,
with higher implant rates across all age groups compared to females. The
annual increase in age-standardised implant rates was higher in males
compared to females (3.5% vs 0.7%, p<0.001). By 2018 the
overall ICD implant rate was 144/million population. Conclusion CIED
implant rates have increased steadily in NZ over the past decade but
remain low compared to international benchmarks. Males had substantially
higher CIED implant rates compared to females, with a growing gender
disparity in ICD implant rates.