Η εξέλιξη των επεμβατικών θεραπειών των αρρυθμιών στην Ελλάδα. Βασίλειος Π. Βασιλικός Καθηγητής Καρδιολογίας ΑΠΘ

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1 Η εξέλιξη των επεμβατικών θεραπειών των αρρυθμιών στην Ελλάδα Βασίλειος Π. Βασιλικός Καθηγητής Καρδιολογίας ΑΠΘ

2 Conflict of interest Sponsored by HCS

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7 Current Situation in Greece 61 pacing centers (51 hospitals) 31 ICD implantation centers (27 hospitals) 16 CRT implanting centers 30 Ablation teams (26 hospitals) 7 University Medical facilities 35% of total EP and Pacing

8 Cardiologists (per million people) Cardiologists per million people & GDP per capita, PPP ($) 300 GRC y = -5,414ln(x) + 139,76 R² = 0, GEO 200 BGR 150 EST CYP HUN ITA MDA KGZ SRB ALB AZE UKR BIH MKD ROU TUR LVA POL KAZ PRT ESC Average CZE SVK SVN ISR MLT ESP FRA DNK FIN BEL SWE ISL DEU AUT NLD IRL CHE NOR LUX GDP per capita, PPP (US $)

9 Electrophysiologists (per million people) Electrophysiologists per million people & GDP per capita, PPP ($) GRC POL y = 2,587ln(x) - 21,162 R² = 0, CZE SWE ISL 8 6 ESC Average LUX LTU DNK SVK MLT ALB HUN 4 SVN EST NOR LVA ESP MKD CYP 2 PRT MDA BGR SRB AZE ROU BIH GDP per capita, PPP (US $)

10 Pacemaker implants

11 Pacemaker type %

12 Pacemaker implantations (per million people) Pacemakers implantations per million people & GDP per capita, PPP(US$) y = 374,18ln(x) ,1 R² = 0,5829 ITA FRA SWE CZE ISL DEU AUT 800 PRT LTU EST POL ESP FIN DNK BEL CHE GRC SVN GBR 600 HRV LVA HUN MLT SVK NLD NOR LUX SRB ISR BGR ESC Average IRL 400 BLR 200 TUN MNE ROU LBN RUS CYP MKD MDA TUR UKR GEO ALB KAZ KGZ ARM DZA EGY BIH 0 AZE 0 MAR GDP per capita, PPP (US $)

13 ICD implants

14 ICD type %

15 ICD implantations (per million people) ICD implantations per million people & GDP per capita, PPP(US$) 400 y = 100,67ln(x) - 919,05 R² = 0,5096 DEU 350 CZE 300 NLD 250 POL ITA DNK 200 FRA SWE 150 ISL BEL IRL CHE NOR LUX FIN SVK ISR HUN ESP AUT 100 GRC EST GBR TUR PRT ESC Average SVN LBN MLT 50 SRB MNE CYP LTU HRV LVA GEO ROU TUN ARM MAR BLR MDA BIH BGR RUS DZA MKD KAZ 0 0 UKR ALB EGY AZE XK GDP per capita, PPP (US $)

16 CRT-P implantations (per million people) CRT-P implantations per million people & GDP per capita, PPP(US$) 80 y = 15,286ln(x) - 131,9 R² = 0,2943 DNK 70 GBR HUN LTU FRA SWE CZE 40 BGR BEL MNE EGY TUN SRB HRV ROU SVN ITA FIN AUT NLD SVK ISL CHE ESC Average EST ISR DEU POL PRT ESP LUX LVA MLT MAR MKD GRC BIH KGZ GEO LBN UKR KAZ CYP 0 DZA 0 ALB IRL GDP per capita, PPP (US $) NOR

17 CRT-D implantations (per million people) CRT-D implantations per million people & GDP per capita, PPP(US$) 180 y = 39,94ln(x) - 361,23 R² = 0,4173 ITA CZE 120 DEU 100 ISR FRA DNK NLD HUN GRC LVA POL SVK MLT PRT SVN ESP GBR FIN BEL SWE AUT IRL CHE NOR LUX LBN ESC Average 20 EST ISL MNE HRV MAR SRB LTU CYP UKR BIH TUN ROU KGZ GEO EGY RUS ALB MKD BGR KAZ 0 AZE 0 ARM DZA GDP per capita, PPP (US $)

18 ICD and PPM/million PPMs ICDs

19 Θεσσαλονίκη-Βηματοδότες

20 Θεσσαλονίκη-Απινιδωτές

21 Ablation: Current Situation in Greece 30 Ablation centers/teams (27 hospitals) 8 University 6 NHS 2 Military 1 Semi-Private 10 Private

22 Ablations (per million people) Ablations per million people & GDP per capita, PPP(US$) 900 y = 219,11ln(x) ,1 R² = 0, DEU 700 DNK 600 CHE CZE BEL 500 FRA NOR 400 FIN SWE NLD HUN AUT LVA EST 300 LTU ESP LUX GBR POL ISR ISL HRV ESC Average SVN IRL 200 SVK TUR PRT RUS SRB GRC MNE CYP 100 TUN BLR GEO KAZ BGR ROU ARM UKR MKD LBN KGZ ALB EGY AZE DZA MLT 0 MAR GDP per capita, PPP (US $)

23 Demographics Number of patients Number of procedures Age (years) Gender 53.8/4 56.3/4 58.7/4 60.9/3 62.2/3 58.3/4 61.5/ / /35. 65/35 (male/femal e) %

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28 %AF centers 7 centers> centers 6 centers> centers 7 centers>100

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34 CHB and PPM implantation

35 Συμπεράσματα Ολες οι πράξεις εκτελούνται με επιτυχία στην Ελλάδα H κατάλυση της ΚΜ είναι η συχνότερη επέμβαση Οι περισσότερες επεμβάσεις γίνονται σε μικρό αριθμό κέντρων Αποτελέσματα άμεσα συγκρίσιμα με αυτά μεγάλων κέντρων του εξωτερικού Σημαντική η συμμετοχή στις Εθνικές καταγραφές

36 AF ablation centers n=655 out of total= centers >100 cases/year, n=562 out of total= centers >50 cases/year, n=579 out of total= centers n=811 out of total= centers >100 cases/year, n=610 out of total= centers >50 cases/year, n=733 out of total= centers n=825 out of total= centers >100 cases/year, n=625 out of total= centers >50 cases/year, n=795 out of total=2262

37 AF ablation (Private vs Public) Public 11 centers, n=303 4 centers >100 cases/year, n=264 out of total=771 5 centers >50 cases/year, n= 270 out of total=823 Private 7 centers, n=235 2 centers >100 cases/year, n=181 out of total=345 3 centers >50 cases/year, n=192 out of total=402 Private Law 1 center, n=117 1 center > 50/100 cases/year, n=117 out of total=238

38 AF ablation (Private vs Public) Public 11 centers, n=372 3 centers >100 cases/year, n=291 out of total=800 7 centers >50 cases/year, n= 334 out of total=1113 Private 8 centers, n=323 2 centers >100 cases/year, n=203 out of total=395 5 centers >50 cases/year, n=283 out of total=586 Private Law 1 center, n=116 1 center > 50/100 cases/year, n=116 out of total=256

39 AF ablation (Private vs Public) Public 11 centers, n=410 4 centers >100 cases/year, n=361 out of total= centers >50 cases/year, n= 381 out of total=1259 Private 9 centers, n=324 2 centers >100 cases/year, n=173 out of total=381 8 centers >50 cases/year, n= 323 out of total=755 Private Law 1 center, n=91 1 center > 50/100 cases/year, n=91 out of total=248