Data from U.S., Europe and Asia-Pacific areas with specific reference to China on worldwide ICD and other devices implantation

International guidelines for implantation of cardiac pacemakers and arrhythmia devices have been primarily promoted and continuously updated by ACC/AHA/NASPE-Heart Rhythm Society in the last 20 years, starting from 1984. These guidelines are today accepted and used in Europe, worldwide and, according to the data of the present overview, also in the Asia-Pacific areas and in China. Furthermore, in the last 5 years, new clinical data from controlled clinical trials on device therapy for patients with cardiac rhythm disturbances have been published. It should be also mentioned that new more sophisticated electrical devices for bradi-tachiarrhythmia have been made available by different technologies manufacturers. Nevertheless, we should recognise that different attitudes of physicians in different countries and different penetration mainly of ICD and CRT therapies can be observed in Europe and in some Asia-Pacific countries in comparison to US, which still is the leading market. Economical reasons and resources limitation are probably the main reasons, but also physicians' reluctance, sometimes inadequate knowledge and incomplete proofs of efficacy are the reason for not introducing in everyday clinical practice, these very expensive technologies, the benefits of which are not completely proved in some subgroups of patients. For these reasons, we undertook, together with US, European and Chinese colleagues, a yearly overview of prevalence and penetration of these technologies in the worldwide market.