Authors' objectives:

On request of the State Secretary of Health, Welfare and Cultural Affairs to inform him about the state of science and its implications for practice, in preparation for a Planning Decree under section 18 of the Hospital Provision Act for tertiary referral centres.

Authors' results and conclusions: Characteristics of cardiac tachyarrhythmias and indications for invasive treatment. Estimated number of procedures 1993-1997. Requirements for providing quality of care. Clinical:Patients with ventricular tachycardia as a late complication of myocardial infraction are eligible for arrhythmia surgery if drug treatment has failed. Patients with atrial fibrillation that cannot be controlled by means of anti-arrhythmic drugs are eligible for radio-frequency ablation. Patients with a documented episode of ventricular fibrillation not caused by acute infarct or an other treatable condition are eligible for an implantable cardioverter defibrillator.

Authors' recommendations: Number of procedures (The Netherlands, 15.5 million inhabitants): 925 radiofrequency catheter ablations, 85 surgical operations and 100 (1993) cardioverter defibrillator implantations rising to 200 in 1997. Requirements: The application of section 18 of the Hospital Provision Act should be continued for catheter ablation and arrhythmia surgery. Defibrillator implantation should be brought under the Act. Requirements for centres performing defibrillator implantation: facilities for carrying out programmed electrophysiological studies, experience with the drug treatment of arrhythmias, arrhythmia surgery and catheter ablation, perform at least ten new defibrillator implants a year, its staff must guarantee intensive counselling and after-care for ICD patients, two experienced cardiologists with a knowledge of ICD's, and technicians on call (24 h/day), implants and relevant follow-up data must be recorded, surgeons and anaesthetists should be experienced in cardiac surgery, though this applies less to the new types of ICD which are inserted transvenously. Implications for practice:Invasive treatment for cardiac tachyarrhythmias must be concentrated in 4 to 6 centers. Other output or dissemination activity: Update report: expected in 2000; Acceptance of recommendations:accepted by the Minister of Health, Welfare and Cultural Affairs; the report has been used for a Planning Decree under section 18 of the Hospital Provision Act for tertiary referral centers. Change to practice:concentration of facilities has been effectuated.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.gr.nl/

Year Published: 1993

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Netherlands

Organisation Name: Health Council of the Netherlands Gezondheidsraad

Contact Address: Postbus 16052, 2500 BB Den Haag, The Netherlands. Tel: +31 70 340 7520;Fax: +31 70 340 7523

Contact Name: info@gr.nl

Contact Email: info@gr.nl

Copyright: Health Council of the Netherlands Gezondheidsraad