Ulvi, M., Bahram, K., Erkin, M., Cecilia, L., Thomas, L., Jacek, B., & J, G.R. (2026). Access to cardiac implantable electronic device therapy in the European Society of Cardiology EuroAsia region: a comparative analysis of implantation activity, infrastructure, and health financing.. European heart journal. Quality of care & clinical outcomes. https://doi.org/10.1093/ehjqcco/qcag099
Ulvi M, Bahram K, Erkin M, Cecilia L, Thomas L, Jacek B, et al. Access to cardiac implantable electronic device therapy in the European Society of Cardiology EuroAsia region: a comparative analysis of implantation activity, infrastructure, and health financing.. European heart journal. Quality of care & clinical outcomes. 2026; doi: 10.1093/ehjqcco/qcag099
Ulvi M, Bahram K, Erkin M, et al. Access to cardiac implantable electronic device therapy in the European Society of Cardiology EuroAsia region: a comparative analysis of implantation activity, infrastructure, and health financing.[J]. European heart journal. Quality of care & clinical outcomes. 2026. DOI: 10.1093/ehjqcco/qcag099.
@article{ulvi2026,
author = {Mirzoyev Ulvi and Kadyrov Bahram and Mirrakhimov Erkin and Linde Cecilia and Lüscher Thomas and Bil Jacek and Gil Robert J},
title = {Access to cardiac implantable electronic device therapy in the European Society of Cardiology EuroAsia region: a comparative analysis of implantation activity, infrastructure, and health financing.},
journal = {European heart journal. Quality of care & clinical outcomes},
year = {2026},
doi = {10.1093/ehjqcco/qcag099},
note = {PMID: 42247583},
}
TY - JOUR AU - Mirzoyev Ulvi AU - Kadyrov Bahram AU - Mirrakhimov Erkin AU - Linde Cecilia AU - Lüscher Thomas AU - Bil Jacek AU - Gil Robert J TI - Access to cardiac implantable electronic device therapy in the European Society of Cardiology EuroAsia region: a comparative analysis of implantation activity, infrastructure, and health financing. T2 - European heart journal. Quality of care & clinical outcomes PY - 2026 DO - 10.1093/ehjqcco/qcag099 AN - PMID:42247583 ER -
AIMS: Access to cardiac implantable electronic device (CIED) therapy varies substantially across Europe, yet data from the European Society of Cardiology (ESC) EuroAsia region remain limited. We aimed to compare implantation activity of pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices across ESC EuroAsia Task Force (TF) countries and to examine how infrastructure, workforce capacity, and health financing patterns relate to device uptake. METHODS AND RESULTS: National-level aggregated data were collected in 2025 through a standardized ESC EuroAsia TF survey and contextualized using European Heart Rhythm Association Atlas indicators and World Bank/World Health Organization Health Expenditure Data. Implantation rates per million population were compared across Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, and Uzbekistan. Pacemaker implantation showed moderate variability (21-333 per million), whereas ICD (0.1-172 per million) and particularly CRT (1-135 per million) implantation demonstrated pronounced disparities. Countries with higher density of implanting centres and greater electrophysiology workforce availability-most notably Georgia-had substantially higher per capita ICD and CRT implantation rates. Exploratory analyses suggested moderate positive correlations between national health expenditure (%gross domestic product) and ICD and CRT implantation rates, whereas financing structure (out-of-pocket vs. government share) showed no consistent association. CONCLUSION: Cardiac implantable electronic device implantation activity in the ESC EuroAsia region follows a clear complexity gradient (PM > ICD > CRT), indicating that access to advanced device therapy is primarily determined by system capacity rather than guideline awareness alone. Strengthening predictable reimbursement pathways, structured referral networks, workforce development, and national registries may reduce inequities and narrow the evidence-practice gap in sudden cardiac death prevention and heart failure management.