The National Survey of Cardiac Pacemakers and Cardioverter Defibrillators

Background: Permanent pacemakers provide effective relief of symptoms and are life-saving in patients with symptomatic heart block. Implantable cardioverter defibrillators (ICD) are also increasingly recognized as life-saving tools in various groups of patients with malignant ventricular tachyarrhythmias. Methods: As part of the “world survey on pacemaker and ICD implantations”, a survey of all device implantations in Iran during the year 2001 was performed. Data was collected and cross-checked through three sources i.e. direct contact with implanting physicians, pacemaker companies and the governmental pacemaker distributing body. Results: During the year studied, 1635 patients received permanent pacemakers. 88% were new implants at an estimated rate of 24 per million population. The mean age of patients was 65 years and 56.2% were male. 40 cardiologists and 19 surgeons implanted the pacemakers at 27 centers throughout the country. Complete heart block was consistently the most common indication at all centers (mean 56.1%), sick sinus syndrome being the next most common one (mean 20.8%). 69% of the pacemakers were single chamber pacemakers. Transvenous insertion of bipolar steroid-eluting passive fixation leads was the predominant practice at most centers. A total of 60 ICDs were implanted at 7 centers by 9 cardiologists. 45% of ICD implants were dual chamber devices. Conclusion: The survey is the only one available right now and provides useful information about the prevailing pacemaker and defibrillator implantation practice in Iran. Future surveys would be facilitated if a standardized implant registry such as that used in Europe were established in this country.