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Heart rhythm charity raises alarm at variable quality of care for patients at risk of sudden cardiac arrest

The latest National Cardiac Rhythm Management (CRM) Audit data released today shows significant variation across the UK in the rates of pacemaker and defibrillator implants, and that the UK lags far behind many of its Western European counterparts. 

CRM devices are life-saving treatments for heart rhythm disorders including blackouts, syncope and sudden cardiac arrest. It is essential that patients get the right diagnosis and the most appropriate treatment, promptly. 

Trudie Lobban MBE, CEO and Founder, Arrhythmia Alliance, the UK’s leading Heart Rhythm Charity, is calling on more to be done to ensure every arrhythmia patient receives equitable treatment, wherever they may live in the UK, and will be raising her concerns to the newly formed All-Party Parliamentary Group on Arrhythmias. 

“Year on year this report gathers more data to demonstrate the amount of work centres are undertaking to serve arrhythmia patients. Whilst we applaud their endeavours it is still very disappointing to see the low implant numbers compared to many of our European partners.” 

She added, “Access to available treatments vary significantly from one area to another which is totally unacceptable. Sudden cardiac death is the number one killer in the UK, yet despite this we still see low implant of life-saving devices such as ICDs and pacemakers. We must now use this data to improve and increase access to care to save more lives and to improve the quality of life for all arrhythmia patients.”

Key findings of the audit include: 

  • Pacemaker and defibrillator implant rates in the UK are gradually increasing, BUT they remain consistently low compared to other Western European countries 
  • There is great variation within the UK in the rates of all types of implants. 
  • The UK is one of the top countries in Europe performing cardiac resynchronisation therapy – a technique that improves the coordination of the heart in patients with heart failure. 
  •  A significant number of UK hospitals continue to perform small numbers of pacemaker and defibrillator implants. For pacemakers, the number of such hospitals has halved in the last year, but for more complex devices, almost 50% of hospitals do not meet the recommended minimal standards.

Dr Francis Murgatroyd, Chair of the British Heart Rhythm Society Audit Committee and Clinical Lead of the CRM Audit said: “This report highlights that the UK implants fewer pacemakers and defibrillators than other European countries. While some parts of the country have good services, in others patients are half as likely to receive the correct diagnosis and treatment, and may be treated in a centre with very low levels of experience. We propose that commissioners and hospitals tackle this issue on a planned, network basis, to establish standards and pathways of care, and ensure that patients receive the correct diagnosis and treatment wherever they live in the UK.” 

The audit commissioned and managed by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patients Outcomes Programme (NCAPOP) covers 1 April 2015 to 31 March 2016. The audit is held by the National Institute for Cardiac Outcomes Research and led clinically by the British Heart Rhythm Society 

The full report can be accessed via the Arrhythmia Alliance website,