• Massimo Zecchin, Marina Torre, Eugenio Carrani, Letizia Sampaolo, Enrico Ciminello, Benedetta Ortis, Renato Ricci, Alessandro Proclemer, Gianfranco Sinagra, and Giuseppe Boriani.
• Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy. Electronic address: massimo.zecchin@asugi.sanita.fvg.it.
• Eur. J. Intern. Med. 2021 Feb 1; 84: 38-45.

AimsTo analyze temporal trends (2001 -2017) of Pacemakers (PM) and Implantable Cardioverter-Defibrillators (ICD) procedures in Italy, according to the national Hospital Discharge Database (HDD).MethodsFrequency and implant rate (IR) in the Italian population were analyzed by age groups (<50, 50-79, ≥80 years).ResultsFrom 2001 (2009 for Cardiac Resynchronization Therapy-Defibrillator - CRT-D) to 2017, first PM implants (1stPM) increased from 36,823 (637/million inhabitants) to 49,716 (820/million), ICD implants from 3,141 (54/million) to 24,255 (400/million) and CRT-D from 2,915 (49/million, 16.5% of ICD) to 8,595 (142/million, 35.4% of ICD). ICD implants due to ventricular tachycardia or ventricular fibrillation decreased from 55.6% to 13.5% and from 15.9% to 4.5% respectively, while the proportion increased among patients with heart failure (from 22.9% to 46.8%), hypertension (from 11.1% to 15.0%), diabetes (from 6.5% to 10.9%), and renal insufficiency (from 4.4% to 7.6%). Both PM and ICD procedures markedly increased in patients ≥80 years old. However, while IR for ICDs increased from 82/million to 1,038/million inhabitants, IR of 1stPM only changed from 6,111/million to 6,212/million as the population in this age group nearly doubled in Italy.ConclusionSince 2001, the increase of 1stPM in Italy was mainly due to the ultra-octogenarian population growth. No differences were observed for IR in each PM age group, while the absolute number and IR increased in all groups (especially ≥80 years old) for ICDs and CRT-Ds. An increase in comorbidities and a reduction in implants for secondary prevention were observed in the ICD population.Copyright © 2020. Published by Elsevier B.V.

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