NICOR: National Institute for Cardiovascular Outcomes Research

NICOR

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Background

Cardiac pacemakers have been implanted in the UK since the early 1960s and have been identified, along with hip replacements, as the most cost effective high volume procedures provided in the NHS.

They can be simple or complex, using one or two electrodes, according to clinical need.

Cardiac ablation is a specialist electrophysiological procedure used to eradicate or modify certain heart rhythm abnormalities.

The Cardiac Rhythm Management Audit aims to monitor the use of implantable devices and interventional procedures for management of cardiac rhythm disorders in UK hospitals.

Since 2000, a new class of devices has emerged called Cardiac Resynchronisation Therapy (CRT) devices. These devices are sophisticated pacemakers that synchronise activation of the right and left ventricles. These are largely used in patients with chronic heart failure. A recent NICE review endorsed CRT as a successful and cost effective therapy.

Heart rhythm disorders are a major cause of disability, and in some cases, sudden death. A modern pacemaker can reduce symptoms when implanted by a simple operation and in the case of a defibrillator, can be life-saving.

The Audit aims 

• to improve the care of patients who undergo pacemaker, ICD and cardiac ablation procedures in the UK
• to look at activity, trends and outcomes in pacing, ICD and cardiac ablation practice in UK hospitals
• to provide assessment of treatments, evaluate associated risk factors and measure long term survival rates of patients who undergo pacemaker, ICD and cardiac ablation procedures in the UK
• to continue to collect and develop the presentation of data from pacemaker, ICD and electrophysiology centres in the United Kingdom (list of all centres in the UK)
• to explore the usage of new software technologies to undertake rapid linkage and analysis of data
• to provide new analyses and outputs of the data as defined by the clinical group
• to receive process and present performance management of audit data.

General Information

• List of current CRM implant centres (xls 103KB)

• AHA/ACC/NASPE 2002 Pacemaker and ICD guidelines (pdf 546KB)

• Guidelines for pacemaker follow up. Report of a British Pacing and Electrophysiology Group (BPEG) Heart, Nov 1996; 76: 458 - 460 (pdf 32KB)

• Recommendations for pacemaker prescription for symptomatic bradycardia. Report of a working party of the British Pacing and Electrophysiology Group. Heart, Aug 1991; 66: 185 - 191 (pdf 1MB)

• UK CRM status for 2006 in response to the European Heart Association survey (pdf 108KB)

• NICE Guidance on the use of ICDs for arrhythmias (pdf 66KB)

• Supporting data from Health Technology Assessments for ICDs (pdf 265KB)

• Current device hardware list Oct 2010 (xls 2572 KB)