The Current Status of Cardiac Electrophysiology in ESC ......The EHRA White Book 2016 . 1 Prof. Béla Merkely EHRA National Cardiac Society Committee Chair (2015–2017) Prof. Pekka

www.escardio.org/EHRA

Algeria · Armenia · Austria · Azerbaijan · Belarus · Belgium · Bosnia & Herzegovina · Bulgaria · Croatia · Cyprus

Czech Republic · Denmark · Egypt · Estonia · Finland · France · Georgia · Germany · Greece · Hungary · Iceland

Ireland · Israel · Italy · Kazakhstan · Kosovo · Kyrgyzstan · Latvia · Lithuania · Luxembourg · Macedonia, FYR · Malta

Montenegro · Morocco · Netherlands · Norway · Poland · Portugal · Romania · Russian Federation · San Marino

Serbia · Slovakia · Slovenia · Spain · Sweden · Switzerland · Turkey · Ukraine · United Kingdom

The EHRA White Book 2016The Current Status of Cardiac Electrophysiology in ESC Member Countries

G. Hindricks, J. Camm, B. Merkely, P. Raatikainen, D. O. Arnar

d7827 - EHRA Pub Membership 148x210.indd 1 25/04/2016 14:48

The EHRA White Book 2016 . 1

Prof. Béla MerkelyEHRA National Cardiac Society Committee Chair (2015–2017)

Prof. Pekka RaatikainenEHRA White Book 2016 Sub-Committee Chair, Member of the EHRA National Cardiac Societies Committee (2015–2017)

Prof. David O. ArnarEHRA White Book 2016 Sub-Committee Co-Chair, Member of the EHRA National Cardiac Societies Committee (2015–2017)

Prof. Gerhard HindricksEHRA President (2015–2017)

Prof. John CammEHRA President Elect (2015–2017)

2 . The EHRA White Book 2016

AcknowledgementsEHRA would like to express its appreciation to BIOTRONIK SE & Co. KG for their continuing support to the EHRA White Book.


The ninth edition of the White Book of the European Heart Rhythm Association (EHRA) provides comprehensive data on electrophysiological procedures and implantation of cardiac implantable electronic devices (CIEDs) in the European Society of Cardiology (ESC) area. The White Book has become a key reference for those seeking information about invasive arrhythmia therapies. No other publication provides up-to-date information on the procedure numbers and educational requirements along with key demographic information and national healthcare statistics.

The EHRA White Book represents a successful and tangible attempt by the leading European professional arrhythmia society to serve its principal mission – to improve the quality of life of the European population by reducing the impact of cardiac arrhythmias and reduce sudden cardiac death. The EHRA White Book is an important reference to monitor the trends in treatment of cardiac arrhythmias in ESC countries as well as to identify possible obstacles to ESC Guidelines implementation in each country.

The data collection is mostly the result of voluntary participation of each National Working Group on Arrhythmias or the National Cardiac Societies. In the vast

majority of the ESC countries, well established centralised databases of both CIEDs and catheter ablation procedures do exist. The databases are often created and maintained by the National Working Group on Arrhythmias and Electrophysiology and/or the National Cardiac Society. However, in some ESC countries no registries are available and the data may be limited. In these cases estimates are provided and clearly indicated where this is the case. The EHRA White Book might serve as motivation and a template for these countries to adopt a systematic approach to key data on arrhythmia therapy. Despite the heterogeneous source of information, there is consistency in the data collection over the years that enables comparison on a year to year basis. This year’s edition includes data from 50 countries of the 56 ESC countries.

The EHRA White Book has been made possible thanks to the efforts of several key contributors. EHRA is grateful to the chairs and co-chairs of the National Working Groups for their continuous support and contribution to White Book. We also like to thank the EHRA staff at the European Heart House, and last but not least the project sponsor, BIOTRONIK SE & Co. KG company and in particular Anja Thümen and Robert Wüstenberg. To all of them, we extend our deepest gratitude and appreciation.

Preface – The EHRA White Book 2016

n Prof. Gerhard Hindricks, EHRA President (2015–2017)

n Prof. John Camm, EHRA President Elect (2015–2017)

n Prof. Béla Merkely, EHRA National Cardiac Society Committee Chair (2015–2017)

n Prof. Pekka Raatikainen, EHRA White Book 2016 Sub-Committee Chair, Member of the EHRA National

Cardiac Societies Committee (2015–2017)

n Dr. David O. Arnar, EHRA White Book 2016 Sub-Committee Co-Chair, Member of the EHRA National

Cardiac Societies Committee (2015–2017)


Table of Contents

The EHRA White Book 2016 . 5 The EHRA White Book 2016 . 5

1. List of Authors


1. List of Authors

Algeria Prof. M.T. Chentir, Co-authors: Prof. M. Ait-Athmane and Prof. A. Meziane-Tani

Armenia Prof. Svetlana Grigoryan, Dr. Zara Kartoyan with special thanks to: Prof. Svetlana Grigoryan

Austria Prof. Daniel Scherr

Azerbaijan Assoc. Prof. Farid Aliyev, Dr. Elnur Isayev, Dr. Fuad Samedovwith special thanks to: Dr. Tural Veliyev, Dr. Samed Samedli, Dr. Rufat Zeynalov

Belarus Assoc. Prof. Alexandr Chasnoits, Dr. Alexander Paceev with special thanks to: Dr. Anna Artishevskaja

Belgium Dr. Yves Vandekerckhove

Bosnia and Herzegovina

Prof. Boris M. Goronja, FESC, Dr. Elnur Tahirovic, Dr. Ivica Markota with special thanks to: Prof. Dragan Uncann, Prof. Elmir Jahic , Prof. Veljko Maric

Bulgaria Dr. Svetoslav Iovev, Dr. Vassil Traykov, Assoc. Prof. Tosho Balabanski

Croatia Dr. Šime Manola, RN, BSN, MSN Ivica Benko

Cyprus Dr. Panayiotis Avraamides, Dr. Pantelis Kourtelaris, Dr. Evagoras Economides with special thanks to: Dr. Eleftherios Nicolaides

Czech Republic Dr. Robert Cihak, Dr. Milos Taborsky, Dr. Jan Bytesnik

Denmark Assoc. Prof. Axel Brandes

Egypt Assoc. Prof. Tamer Fahmy, Assoc. Prof. Mazen Tawfik, Assoc. Prof. Rania Samir with special thanks to: Prof. Said Khalid, President of ECRA, Prof. Wagdy Galal, Past President of ECRA

Estonia Dr. Jüri Voitk, Dr. Indrek Roose

Finland Prof. Pekka Raatikainen with special thanks to: RN Outi Raatikainen

France Dr. Nicolas Sadoul, Dr. Serge Boveda with special thanks to: C. Durand, P. Stiegler, H. Berthault, M. Mainardis, G. Waque

Georgia Dr. Giorgi Papiashvili

EHRA would like to express a sincere thank you to those below who took their time collecting, researching and compiling valuable information about their current status of treatment of arrhythmias. They should be considered coauthors of this book:


Germany Prof. Thomas Deneke, Dr. Christopher Piorkowski

Greece Dr. Antonios Sideris with special thanks to: Dr. Sotirios Xydonas, Dr. Michael Efremidis

Hungary Dr. Gabor Duray, Dr. Marcell Clemens

Iceland Dr. Sigfus Gizurarson, Dr. Kristjan Gudmundsson

Ireland Dr. David Keane

Israel Dr. Roy Beinart

Italy Dr. Giovanni Luca Botto, Prof. Giuseppe Boriani, Dr. Renato Pietro Ricci with special thanks to: Prof. Luigi Padeletti, Florence, Dott. Alessandro Proclemer, Udine, Dott. Massimo Zecchin, Trieste

Kazakhstan Prof. Salim Berkinbayev, Dr. Ayan Abdrakhmanov

Kosovo Assoc. Prof. Gani Bajraktari, Dr. Artan Ahmeti

Kyrgyzstan Prof. Erkin Mirrakhimov, Assoc. Prof. Alina Kerimkulova

Latvia Prof. Oskars Kalejs, Dr. Maija Vikmane, Dr. Aldis Strelieks with special thanks to: Prof. Oskars Kalejs, Dr. Baiba Lurina

Lithuania Prof. Germanas Marinskis, Prof. Aras Puodziukynas, Dr. Ausrius Poviliunas

Luxembourg Dr. Camille Pesch, Dr. Carlo Dimmer, Dr. Laurent Groben

Macedonia FYR Assoc. Prof. Nikola Gjorov with special thanks to: Dr. Lidija Poposka – University Clinic for Cardiology, Dr. Oliver Buljetic – Acibadem|Sistina Clinical Hospital, Dr. Zan Zimbakov – Special Hospital Filip

Malta Dr. Mark Sammut with special thanks to: Mr. Daniel Demicoli for providing data

Montenegro Prof. Ljilja Music, Dr. Mihailo Vukmirovic, Ass. Vesna Kontic with special thanks to: Enes Vatic, Andjela Kostic

Morocco Prof. Salima Abdelali, Prof. Ibtissam Fellat, Prof. Ali Chaib with special thanks to: Mrs Najat Bourhim And Mr Amine Nekker

Netherlands Dr. Geert-Jan Kimman


1. List of Authors

Norway Dr. Erik Kongsgård, Dr. Eivind Stoud Platou with special thanks to: Torkel Steen, OUS-UUS

Poland Dr. Oskar Kowalski, Prof. Jarosław Kažmierczak

Portugal Dr. Pedro Silva Cunha, Dr. Pedro Nuno Carlos Marques, Dr. Helena Gonçalves Sousa

Romania Dr. Alexandru Deutsch, Dr. Mihaela Grecu with special thanks to: the representives of centers who responded to survey

Russian Federation

Prof. Amiran Revishvili with special thanks to: Vladislav Kuptsov. Secretary General of the NSCA

San Marino Dr. Liano Marinelli, Dr. Marina Foscoli, Dr. Marco Zavatta

Serbia Prof. Siniša U. Pavlovic, Dr. Bratislav Kircanski, Dr. Nikola Radovanovic with special thanks to: Prof. Goran Milašinovi – Director of National Referral Pacemaker center Clinical Center of Serbia

Slovakia Dr. Gabriela Kaliska with special thanks to: Dr. Silvia Misikova

Slovenia Prof. Peter Rakovec

Spain Dr. Nicasio Perez-Castellano, Dr. Jose M. Guerra with special thanks to: Dr. Javier Alzueta, Dr. Oscar Cano, Dr. Alonso Pedrote

Sweden Prof. Carina Blomström Lundqvist, Dr. Fredrik Gadler, Dr. Helena Malmborg, Dr. Jonas Schwieler, Dr. David Mörtsell with special thanks to: Dr. Magnus Forsgren

Switzerland Prof. Haran Burri with special thanks to: Mr. Istvan Babotai, Dr. Jürg Fuhrer (responsible for the national EP and device registry)

Turkey Dr. Emin Evren Özcan, Dr. Mesut Demir, Dr. Dursun Aras

Ukraine Prof. Oleg Sychov, Dr. Artem Borodai with special thanks to: Biskub I, Bondarchuk S, Bugaev M, Burkovskii S, Gritsay A, Doronin O, Burdeinyi I, Kachan O, Karpenko J, Klantsa A, Komiati V, Kushnir N, Lisohub S, Marcienko I, Matlah A, Malyarchuk R, Melnitchuk M, Nikitan S, Notova G, Oleinik V, Pohilko S, Popov S, Posudevskii S, Pravosudovich S, Protsik V, Puziryov G, Sarazhin K, Volkov D, Zubenko K

United Kingdom

Dr. Nick Linker, Dr. David Cunningham


2. Scope and Methodology


2. Scope and Methodology

The EHRA White Book 2016 is the 9th edition of a project that was launched in an attempt to understand the national realities with regard to treatment of cardiac arrhythmias.

Every year EHRA invites all the countries member of the European Society of Cardiology to participate in this project. This year the data were collected in the period from February 2016 to May 2016. Like in the past most of the ESC countries provided up-to-date data for this year’s edition.

In this edition, the following sections are available for all participating countries:

1. Statistics information 2. Country 3. Healthcare system 4. Education & Quality Control 5. Pacemakers 6. Cardiac resynchronization therapy devices 7. Implantable cardiac defibrillator 8. Loop recorders 9. Lead extractions 10. Device specific information 11. Interventional electrophysiology 12. Guidelines 13. Sources

Since the beginning of the project in 2008 the data for the EHRA White Book have been collected by surveying national cardiology societies and working groups of cardiac pacing and electrophysiology of each country.

The chairmen of the societies and/or working groups were responsible for compiling information about their country based on a questionnaire. The data gathered by the societies and working groups were mainly from national registries and national health institutions.

Simultaneously, a secondary investigation was conducted to cross verify and build the quantitative and qualitative information contained in the book. Once the data collection was complete, the national societies or working groups were asked to authorise the publication of the information.


3. Sources for Demographic Information


3. Sources for demographic information

The demographic information for each country was taken from the following sources:

Age pyramid

United States Census Bureau (Homepage)

http://www.census.gov/ipc/www/idb/informationGateway.php

February 12, 2016

Healthcare data

Hospitals (per 100 000 population) European health for all database (HFA-DB) http://data.euro.who.int/hfadb/

February 16, 2016

Beds (per 100 000 population) European health for all database (HFA-DB) http://data.euro.who.int/hfadb/

February 16, 2016

Density of physicians (per 1000 population)

European health for all database (HFA-DB)http://data.euro.who.int/hfadb/

February 16, 2016

Density of nurses (per 1000 population)

European health for all database (HFA-DB)http://data.euro.who.int/hfadb/

February 16, 2016

Demographic information

Population United States Census Bureau (Homepage)http://www.census.gov/ipc/www/idb/informationGateway.php

February 17, 2016

Population annual growth rate (%) United States Census Bureau (Homepage)http://www.census.gov/ipc/www/idb/informationGateway.php

February 17, 2016

Life expectancy at birth (in years) United States Census Bureau (Homepage)http://www.census.gov/ipc/www/idb/informationGateway.php

February 17, 2016

Death rate (per 1000 population) European health for all database (HFA-DB)http://data.euro.who.int/hfadb/

February 16, 2016

Live births (per 1000 population) European health for all database (HFA-DB)http://data.euro.who.int/hfadb/

February 17, 2016

Economic information

Gross domestic product (U.S. dollar-billions)

International Monetary Fund (IMF)http://www.imf.org/external/ns/cs.aspx?id=28

February 17, 2016

Gross domestic product per capita (U.S. dollar-units)

International Monetary Fund (IMF)http://www.imf.org/external/ns/cs.aspx?id=28

February 17, 2016

Total expenditure on health as % of GDP

European health for all database (HFA-DB) http://data.euro.who.int/hfadb/

February 17, 2016

General government expenditure on health as % of total expenditure on health

WHO -World Health Statistics Report 2015; Section 7; February 17, 2016

Private expenditure on health as % of total expenditure on health

WHO -World Health Statistics Report 2015; Section 7; February 17, 2016


4. ESC Countries Overview

Alg

eria


ALGERIA


1. Statistics

Age pyramid for Algeria

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*

* 1990 or last available

Alg

eria


Healthcare data Year

Hospitals (per 100.000 population) not available not available

Beds (per 100.000 population) not available not available

Density of physicians (per 1.000 population) not available not available

Density of nurses (per 1.000 population) not available not available

Demographic information Year

Population 39.542.166 2015

Population annual growth rate (%) 1,9 2015

Life expectancy at birth (in years) 77 2015

Death rate (per 1.000 population) not available not available

Live births (per 1.000 population) not available not available

Economic information Year

Gross domestic product (U.S dollar-billions) 175,08 2015*

Gross domestic product per capita (U.S dollar-units) 4.345,43 2015*

Total expenditure on health as % of GDP not available not available


73,5 2012


26,5 2012

* IMF estimative

2. Country

Proportion of deaths resulting from cardiovascular disease

2014 2015

not available not available


3. Healthcare System

Public facilities and some small to middle sized private clinics

Basic insurance availability Yes

Requirements for citizens to qualify for public insurance: To provide vaccinations, coverage of communicable diseases and the main chronic diseases ( diabetes...)

Percentage of insured and uninsured citizens

2014 2015

Insured citizens 70 % 70 %

Uninsured citizens 30 % 30 %

Distribution of insurance modality

2014 2015

Public insurance company 100 % 100 %

Private insurance company 0 % 0 %

Private co-payment 0 % 0 %

Possibility to subscribing to private health insurance plans Yes

Co-payment necessary for the following therapy

ICD devices No

Pacemakers Yes

Ablation No

Comments: Pacemakers in private structures. ICD and ablation only in public hospitals

Reimbursement availability for physicians and hospitals

Physician/Hospital receives per process

reimbursement

Physician/Hospital does not receive reimburse-

ment, but incentives (e.g. more salary on the

following year)

Physician/Hospital does not receive reimburse-ment neither incentive

No answer

Physician Hospital Physician Hospital Physician Hospital Physician Hospital

Internal loop recorders

ICD primary prevention

ICD secondary prevention

CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Physicians receive salaries in public structures; Coverage by hospitals according to their own budget

Alg

eria


Treatment availability

No restrictions

No restrictions, but the indications have to follow the ESC guidelines

No restrictions, but the indications have to follow the National guidelines

Restricted to certain number of treatments/budget

Not funded

No answer

Comments: Consensus between physicians to follow ESC guidelines

4. Education and Quality Control

National certification availability

Yes, it´s required for

practice

Yes, but it´s not required

for practice

No No answer Official name

Device therapy

Invasive electrophysiology

Allied professionals

Training centres

National Cardiac Society supporting EHRA certification system

Yes, the Society demands EHRA certification for practice

Yes, the Society advises EHRA certification and homologates national certification

Yes, the Society advises EHRA certification, but it does not homologate national certification

No

No answer

Specialist required for

Specialist

Catheter ablation Yes Cardiologist

ICD or pacemaker implants Yes Cardiologist

Official national competency guidelines for electrophysiological studies or catheter ablation

No

Required period of training to perform implantations No

Suggested period of training to perform implantations Yes

1 year


5. Pacemakers

Specialist performing implants

Cardiologists Yes 99 %

Surgeons Yes 1 %

Pacemaker units implanted and number of implanting centres

2014 2015

Implanting centres 19 19

Total Pacemaker units implanted 2.508 2.915

Thereof, Leadless Pacemaker not available 0

First implants 1.957 2.303

Replacements 551 612

Willingness to install quality control system Yes

Responsible person for quality control

To be defined

Training centres availability

Pacemaker 11

ICD implantation 7

CRT implantation 3

Electrophysiological studies and catheter ablation 2

Atrial fibrillation ablation 0

National quality control system availability No

Number of universities (Schools of Medicine) 10

Percentage of academic centres among all practicing EP centres 100 %

Percentage of academic centres among all practicing implanting devices centres 100 %

Alg

eria


6. Cardiac resynchronization therapy devices

CRT units implanted and number of implanting centres

2014 2015


Total CRT units implanted 56 108

Thereof, CRT pacemaker 20 53

Thereof, CRT ICD 36 55



Surgeons No 0 %

7. Implantable Cardiac Defibrillator

ICD units implanted and number of implanting centres

2014 2015


Total ICD units implanted 60 91

Thereof, Single chamber 25 76

Thereof, Dual chamber 35 15

Thereof, Subcutaneous ICD not available 0

First implants 50 85

Replacements 10 6



Surgeons No 0 %

8. Loop recorders

Loop recorders implanted and number of implanting centres

2014 2015


Total loop recorders implanted 6 15



Surgeons No 0 %


10. Device specific

Availability of remote monitoring of devices No answer

9. Lead extractions

Lead extractions procedures and and number of centers that performed lead extractions

2014 2015

Hospitals performed lead extractions 2 3

Total lead extraction procedures 56 41

Specialist performing lead extractions


Surgeons Yes 3 %

National registry for

Official name

ICD No

Pacing No

Electrophysiology No

Availability of a national institution coordinating and guiding device recalls and complications related to lead extractions

No

Availability of a national quality insurance system or complication registry No

Alg

eria


Availability of a national registry for interventional electrophysiology No

11. Interventional electrophysiology

Number of ablations performed and number of centres

2014 2015

Number of ablation centres 2 3

Number of ablations performed 240 303

Mean number of ablations per centre 120 101

Number of AF ablations 0 0

Number of ablation centres (> 50 AF ablations) 0 0

Number of VT/VF ablations 5 8

Number of ablation centres (> 10 VT ablations on structural heart diseases) 0 0

Number of LAA closures 0 0

Number of centres (LAA closures) 0 0

Number of electrophysiologists

Number of electrophysiologists performed catheter ablation independently 3 5

Number of physicians under training to become independent electrophysiologists 5 4

12. Guidelines

Guidelines adhered to ICD implants and pacemaker implants

National No

U.S. No

European Yes

Obstacles to guideline implementation Ranking of importance

1 2 3 4 5

Lack of centres 2

Lack of reimbursement, limited financial resources

3

Lack of referral 5

Lack of trained personnel 4

Low awareness of guidelines 6

Lack of operators 1

1 = no obstacle, 5 = great obstacle 1 = top, 6 = lowest


13. Sources

Name of National Cardiac Society, National Working Group or arrhythmia body

Algerian Society of Cardiology Working Group on Cardiac arrhythmias

All sources that were used to fill out the questionnaire for the EHRA White Book 2016

EHRA White Book 2015

Survey from professional association

Sales data

Estimation

Arm

enia


ARMENIA


1. Statistics

Age pyramid for Armenia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Arm

enia



Hospitals (per 100.000 population) 4,3 2013

Beds (per 100.000 population) 406,0 2013

Density of physicians (per 1.000 population) 2,8 2013

Density of nurses (per 1.000 population) 5,0 2013


Population 3.056.382 2015

Population annual growth rate (%) -0,1 2015


Death rate (per 1.000 population) 9,1 2012

Live births (per 1.000 population) 13,8 2013




Total expenditure on health as % of GDP 4,5 2013


41,8 2012


58,2 2012

* IMF estimative

2. Country


2014 2015

48 % 48 %



The Armenian healthcare system contains of two parts: state and private health system. Medical care is financed by state in some: 1) children 0-7 years old, 2) some emergency medical care ( co-payment): 3) military men (co-payment); 4) risk groups (very few income).

Basic insurance availability No


2014 2015




2014 2015






ICD devices Yes

Pacemakers Yes

Ablation Yes



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Arm

enia



No restrictions




Not funded

No answer




practice


for practice


Device therapy


Allied professionals Cardiology

Training centres Yerevan State medical

University after M.Heracy





No

No answer


Specialist

Catheter ablation No

ICD or pacemaker implants No


No


Suggested period of training to perform implantations No



5. Pacemakers



Surgeons No 0 %


2014 2015


Total Pacemaker units implanted 129 117



Replacements 28 10



Perhaps the Armenian Arrhythmological Association


Pacemaker 1

ICD implantation 1

CRT implantation 1






Arm

enia




2014 2015







Surgeons No 0 %



2014 2015







Replacements 11 4



Surgeons No 0 %


10. Device specific

Availability of remote monitoring of devices No

Reasons why remote monitoring is not available: We have not the monitoring system of devices

8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %


Cardiologists No 0 %

Surgeons No 0 %


Official name

ICD No

Pacing No



No


Arm

enia





2014 2015













12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres


1

Lack of referral 3

Lack of trained personnel


Lack of operators



13. Sources


Armenian Arrhythmological Association



Official statistics


Au

stri

a


AUSTRIA


1. Statistics

Age pyramid for Austria

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Au

stri

a


















75,9 2012


24,1 2012

* IMF estimative

2. Country


2014 2015

43 % 42 %



The Austrian healthcare system is characterized by the federalist structure of the country, the delegation of competencies to self-governing stakeholders in the social insurance system as well as by cross-stakeholder structures at federal and Länder level which possess competencies in cooperative planning, coordination and financing. According to the Federal Constitution, almost all areas of the healthcare system are primarily the regulatory responsibility of the federal government. The most important exception is the hospital sector. In this area, the federal government is only responsible for enacting basic law; legislation on implementation and enforcement is the responsibility of the nine Länder. In the outpatient sector, but also in the rehabilitation sector and in the field of medicines, healthcare is organized by negotiations between the 21 health insurance funds and the Federation of Austrian Social Insurance Institutions on the one hand and the chambers of physicians and pharmacists (which are organized as public-law bodies) and the statutory professional associations of midwives or other health professions on the other. The various sectors of the health care system have traditionally been characterized by different stakeholders and regulation- and financing mechanisms. However, in recent years there have been increased efforts to introduce decision-making and financing flows which are effective across all sectors. Since 2002, all the Länder (except Vienna) as well as some of the private non-profit owners have privatized their hospitals, mainly in the form of organizational privatizations. The various private operating companies have one thing in common: they are responsible for the management of hospitals, whereas the Länder or local authorities as (majority) owners usually act as a guarantor. The Austrian healthcare system has developed almost completely into a model which is mainly based on decentralized contracts with all service providers. [Health systems in transition, Hofmarcher 2006]


All citizens with a minimum salary / payment of 416 Euro qualify for public healthcare insurance.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No

Au

stri

a



No restrictions




Not funded

No answer



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD




practice


for practice


Device therapy ICD and PM Accreditation

Invasive electrophysiology EP Accreditation


Training centres





No

No answer



Specialist


ICD or pacemaker implants Yes Cardiologist, surgeon


No




No answer


Pacemaker 57

ICD implantation not available

CRT implantation not available








Au

stri

a


5. Pacemakers



Surgeons Yes 50 %


2014 2015



Thereof, Leadless Pacemaker not available not available


Replacements 2.328 2.194



2014 2015


Total CRT units implanted 1.236 1.364





Surgeons Yes 50 %




2014 2015


Total ICD units implanted 1.362 1.393

Thereof, Single chamber not available not available

Thereof, Dual chamber not available not available

Thereof, Subcutaneous ICD not available not available

First implants 976 1.045




Surgeons Yes 90%

8. Loop recorders


2014 2015





Surgeons Yes 20 %

9. Lead extractions


2014 2015





Surgeons Yes 90 %

Au

stri

a


10. Device specific

Availability of remote monitoring of devices Yes


Official name

ICD Yes

Pacing Yes

Electrophysiology Yes


No


Availability of a national registry for interventional electrophysiology Yes

Official name: EP Registry of the Working Group of Rhythmology



2014 2015


Number of ablations performed 2.622 2.777






Number of LAA closures not available 50

Number of centres (LAA closures) not available 10



Number of physicians under training to become independent electrophysiologists

10 17


12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 1


4

Lack of referral 6



Lack of operators 2


13. Sources


Working Group of Rhythmology, Austrian Society of Cardiology



Official statistics


Estimation

Aze

rbai

jan


AZERBAIJAN


1. Statistics

Age pyramid for Azerbaijan

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Aze

rbai

jan


















22,6 2012


77,4 2012

* IMF estimative

2. Country


2014 2015

not available 50 %



Medicine is free of charge for all citizens in governmental hospitals.



2014 2015




2014 2015






ICD devices Yes

Pacemakers No

Ablation Yes



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Aze

rbai

jan



No restrictions




Not funded

No answer




practice


for practice


Device therapy


Allied professionals Certification of the Ministry of Health

Training centres





No

No answer


Specialist




No




5. Pacemakers



Surgeons Yes 10 %


2014 2015




First implants not available 352

Replacements not available 43


Ministry of health


Pacemaker 6

ICD implantation 3

CRT implantation 1








Aze

rbai

jan




2014 2015







Surgeons No 0 %



2014 2015






First implants not available not available

Replacements not available not available

8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons No 0 %


10. Device specific


Reasons why remote monitoring is not available: Unclear

9. Lead extractions


2014 2015





Surgeons No 0 %


Official name

ICD No

Pacing No



No


Aze

rbai

jan





2014 2015





Number of ablation centres (> 50 AF ablations) 2 not available

Number of VT/VF ablations 56 not available








12. Guidelines


National No

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres


Lack of referral


Low awareness of guidelines

Lack of operators



13. Sources


Azerbaijan Society of Cardiology, Arrhythmia Working Group



Official statistics


Sales data

Bel

aru

s


BELARUS


1. Statistics

Age pyramid for Belarus

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Bel

aru

s




Beds (per 100.000 population) 1.104,6 2013














77,2 2012


22,8 2012

* IMF estimative

2. Country


2014 2015

54,3 % 55,15 %



National Health System


Requirements for citizens to qualify for public insurance: Citizenship


2014 2015




2014 2015


Private insurance company not available not available

Private co-payment not available not available



ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Leadless Pacing and Subcutaneous ICD not available in the country

Bel

aru

s



No restrictions




Not funded

No answer




practice


for practice


Device therapy Roentgen-Endovascular surgery Diploma

Invasive electrophysiology Roentgen-Endovascular surgery Diploma


Training centres





No

No answer


Specialist

Catheter ablation Yes Roentgen-Endovascular surgery Diploma

ICD or pacemaker implants Yes Roentgen-Endovascular surgery Diploma


No


5. Pacemakers



Surgeons Yes 100 %


2014 2015







Health Ministry


Pacemaker 1

ICD implantation 1

CRT implantation 1






Willingness to install quality control system No answer


Required period of training to perform implantations Yes

4 months


1 year

Bel

aru

s




2014 2015



Thereof, CRT pacemaker not available not available

Thereof, CRT ICD not available not available



Surgeons Yes 100 %



2014 2015








8. Loop recorders


2014 2015





Surgeons Yes 100 %



Surgeons Yes 100 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 100 %


Official name

ICD No

Pacing No



No


Bel

aru

s





2014 2015











Number of electrophysiologists performed catheter ablation independently not available not available


1 0

12. Guidelines


National Yes

U.S. No

European No


1 2 3 4 5

Lack of centres 6


1

Lack of referral 4



Lack of operators 2



13. Sources


Belorussian Heart Rhythm Association a branch of Belorussian Scientific Society of Cardiologists



Official statistics

Estimation

Bel

giu

m


BELGIUM


1. Statistics

Age pyramid for Belgium

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Bel

giu

m








Population 11.323.973 2015










75,2 2012


24,8 2012

* IMF estimative

2. Country


2014 2015




National and obligatory for everybody


Requirements for citizens to qualify for public insurance: citizenship


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation Yes



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Bel

giu

m



No restrictions




Not funded

No answer

Comments: ICD: prescription under national guidelines and limited budget per center; ILR: recorder reimbursed for a limited number per year, physician and hospital not reimbursed.




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiac surgery has to be on site

ICD or pacemaker implants Yes Cardiac surgery has to be on site


Yes

Ministry healthcare




5. Pacemakers


Cardiologists Yes not available

Surgeons Yes not available


2014 2015





Replacements 3.977 not available


PM and ICD: Ministry Healthcare • Ablation: Working Group (BeHRA)


Pacemaker not available



Electrophysiological studies and catheter ablation not available

Atrial fibrillation ablation not available




National quality control system availability Yes

Pacemaker Yes

ICD implantation Yes

CRT implantation Yes

Cathether ablation Yes

Bel

giu

m




2014 2015










2014 2015





Thereof, Subcutaneous ICD 25 82






8. Loop recorders


2014 2015

Implanting centres not available not available

Total loop recorders implanted not available 400






10. Device specific


9. Lead extractions


2014 2015

Hospitals performed lead extractions not available not available

Total lead extraction procedures not available not available





Official name

ICD Yes QERMID@DEFIBRILLATORS

Pacing Yes QERMID@PACEMAKERS



No

Bel

giu

m



BEHRA national ablation database

12. Guidelines


National Yes

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators




2014 2015

Number of ablation centres 44 not available


Mean number of ablations per centre 139 not available

Number of AF ablations 2.560 3.273


Number of VT/VF ablations not available not available

Number of ablation centres (> 10 VT ablations on structural heart diseases) not available not available

Number of LAA closures not available not available

Number of centres (LAA closures) not available not available






13. Sources


BeHRA



Official statistics


Estimation

Bo

snia

& H

erze

go

vin

a


BOSNIA & HERZEGOVINA


1. Statistics

Age pyramid for Bosnia & Herzegovina

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Bo

snia

& H

erze

go

vin

a


2. Country


2014 2015

53 % 52 %








Population annual growth rate ( %) -0,1 2015









71,2 2012


28,8 2012

* IMF estimative



The National Healthcare system in BH is provided through an established network of health centers of Family Medicine (primary care). As a secondary and tertiary cere, General hospitals, University Clinical Centers, University hospitals and special institutions are providind services. A few private healtcares are incorporated to the healthcare system.



2014 2015




2014 2015


Private insurance company 0 % not available


Possibility to subscribing to private health insurance plans No


ICD devices Yes

Pacemakers Yes

Ablation No answer

Comments: It is mandatory the payment of 20% of all implant costs for patients under 65 years old.



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Bo

snia

& H

erze

go

vin

a



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation No answer

ICD or pacemaker implants Yes Cardiologist, Surgeon


No


Suggested period of training to perform implantations No answer


5. Pacemakers



Surgeons Yes 15 %


2014 2015





Replacements 73 61



Head of the Pacemaker Center/Department


Pacemaker 0

ICD implantation 0

CRT implantation 0






National quality control system availability No answer

Bo

snia

& H

erze

go

vin

a




2014 2015







Surgeons No 0 %



2014 2015







Replacements 7 6



Surgeons Yes 15 %

8. Loop recorders


2014 2015





Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015




Cardiologists No not available

Surgeons No not available


Official name

ICD No

Pacing No



No


Bo

snia

& H

erze

go

vin

a





2014 2015


Number of ablations performed 0 not available

Mean number of ablations per centre not available not available




Number of ablation centres (> 10 VT ablations on structural heart diseases) 0 not available






12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Working Group for Cardiac Pacing / Association of Cardiologist in Bosnia and Herzegovina(President: Asist. Prof. Dr. Boris Goronja, FESC)

Working Group for Cardiac Pacing / Cardiac Sociaty of Republic of Srpska (President: Asist. Prof. Dr. Dragan Uncanin, FESC; FACC)




Bu

lgar

ia


BULGARIA


1. Statistics

Age pyramid for Bulgaria

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1993*

40–64 years

2030

2015

1993*

20–39 years

2030

2015

1993*

< 20 years

2030

2015

1993*


Bu

lgar

ia

















General government expenditure on health as % of total expen-diture on health

56,3 2012


43,7 2012

* IMF estimative

2. Country


2014 2015

64 % 65 %



The healthcare system is financed by a single health insurance fund – The National Health Insurance Fund. Paying health insurance to this fund is mandatory for all Bulgarian citizens in the age 18-retirement age. This fund covers the outpatient and inpatient healthcare. In addition there are some private funds that are used as additional health insurance funds to provide higher level of health insurance. Paying installments to the latter is not mandatory.


Requirements for citizens to qualify for public insurance: all citizens qualify for public insurance. In citizens in working age (aged 18 until retirement) are insured if they pay the installments regularly. Children, minors and the retired are insured by the state.


2014 2015




2014 2015






ICD devices Yes

Pacemakers No

Ablation Yes

Comments: ICD implantation needs co-payment because the reimbursement rate is too low to cover the whole cost for the implant. • Pacemaker implantation does not require co-payment in the majority of the centers. • Some ablation procedure (usually complex ablations requiring three dimensional mapping) were co-paid at some centers.

Bu

lgar

ia



No restrictions




Not funded

No answer



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: ICD implantation is reimbursed only partially so that the hospital receives reimbursement which does not cover the whole cost of the device. • CRT-P devices are fully reimbursed. • Ablations are reimbursed with a fixed amount of money not taking into account the real cost of all the consumables. • Leadless pacing, S-ICDs and ILRs were not reimbursed. As an exception partial reimbursement could be possible.




practice


for practice


Device therapy The National standard for device therapy and invasive electrophysiology


The National standard for device therapy and invasive electrophysiology

Allied professionals The National standard for device therapy and invasive electrophysiology

Training centres The National standard for device therapy and invasive electrophysiology

Comments: There is limited reimbursement for ICDs and CRT-D devices. Co-payment needed.



Specialist


ICD or pacemaker implants Yes Cardiologist, Cardiac surgeon could perform pacemaker implantation only


Yes

The National standard for device therapy and invasive electrophysiology


2 years


2 years



There is nobody specifically responsible for quality control in the field of EP and devices


Pacemaker 2

ICD implantation 2

CRT implantation 1








No

No answer

Bu

lgar

ia


5. Pacemakers



Surgeons Yes 10 %


2014 2015











2014 2015







Surgeons No 0 %


8. Loop recorders


2014 2015

Implanting centres 1 not available

Total loop recorders implanted 5 not available

9. Lead extractions


2014 2015

Hospitals performed lead extractions 0 not available

Total lead extraction procedures 0 not available



Surgeons No 0 %



Surgeons No 0 %



Surgeons No 0 %



2014 2015







Replacements 15 15

Bu

lgar

ia


10. Device specific



Official name

ICD Yes Professional National Registry – “Bg Pace”

Pacing Yes Professional National Registry – “Bg Pace”

Electrophysiology Yes Professional National Registry – “Bg Ephy”


Official name: Professional National Registry – “Bg Ephy”


No

Availability of a national quality insurance system or complication registry Yes

Official name: Professional National Registry – “Bg Pace” Professional National Registry – “Bg Ephy”



2014 2015













7 5



1 2 3 4 5

Lack of centres 6


1

Lack of referral 2



Lack of operators 5


13. Sources


Professional association Electrophysiology and Cardiac Pacing



Official statistics


Other

12. Guidelines


National No

U.S. No

European Yes

Cro

atia


CROATIA


1. Statistics

Age pyramid for Croatia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Cro

atia



Hospitals (per 100 000 population) 1,6 2013

Beds (per 100 000 population) 585,9 2013

Density of physicians (per 1000 population) 3,0 2013

Density of nurses (per 1000 population) 6,6 2013





Death rate (per 1000 population) 11,8 2013

Live births (per 1000 population) 9,4 2013






80,1 2012


19,9 2012

* IMF estimative

2. Country


2014 2015

49 % 49 %



The Croatian healthcare system is based on the stately owned Health Insurance Institute in addition to poorly developed private insurances.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Cro

atia



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist


ICD or pacemaker implants Yes Cardiologist or Surgeon


No




5. Pacemakers



Surgeons Yes 10 %


2014 2015








National Cardiac Society


Pacemaker 5

ICD implantation 5

CRT implantation 5







Cro

atia




2014 2015







Surgeons No 0 %



2014 2015







Replacements 21 40



Surgeons Yes 5 %

8. Loop recorders


2014 2015





Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons No 0 %


Official name

ICD No

Pacing No



No


Cro

atia





2014 2015


Number of ablations performed 852 1.348











3 7

12. Guidelines


National No

U.S. No answer

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Croatian Cardiac Society, Working Group on Arrhythmias and Cardiac Pacing



Croatian Health Insurance Institute

Working Group on Arrhythmias and Cardiac Pacing of Croatian Cardiac Society

Cyp

rus


CYPRUS


1. Statistics

Age pyramid for Cyprus

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Cyp

rus



Hospitals (per 100 000 population) 9,5 2013

Beds (per 100 000 population) 341,7 2013

Density of physicians (per 1000 population) 3,2 2013

Density of nurses (per 1000 population) 5,2 2013





Death rate (per 1000 population) 6,4 2012

Live births (per 1000 population) 10,8 2013






47,0 2012


53,0 2012

* IMF estimative

2. Country


2014 2015

30 % 30 %



Free medical care is provided by government hospitals and health centres based on income criteria.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: The above applies to the state sector only. In state hospitals the physician is given a flat salary for all work carried out. Private centres operate with varying incentives • The state hospitals provide the therapies as judged by the physicians. The therapies are paid for centrally by the ministry of health.

Cyp

rus



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Electrophysiologist



No




5. Pacemakers



Surgeons No 0 %


2014 2015







The medical centers where the procedure takes place


Pacemaker 2

ICD implantation 2

CRT implantation 2








Cyp

rus




2014 2015



Thereof, CRT pacemaker not available not available

Thereof, CRT ICD not available not available



Surgeons No 0 %



2014 2015








8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons No 0 %


10. Device specific


Reasons why remote monitoring is not available: Short distances and close relationship between patient and doctor render unnecessary remote monitoring.

9. Lead extractions


2014 2015





Surgeons No 0 %


Official name

ICD No

Pacing No



No


Cyp

rus





2014 2015













0 0

12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 6


3

Lack of referral 2



Lack of operators 4



13. Sources


Cyprus Working Group on Cardiac Electrophysiology and Pacing



Official statistics


Sample short survey

Estimation

Personal communication

Cze

ch R

epu

blic


CZECH REPUBLIC


1. Statistics

Age pyramid for Czech Republic

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Cze

ch R

epu

blic








Population 10.644.842 2015






Gross domestic product (U.S. dollar-billions) 182,46 2015*

Gross domestic product per capita (U.S. dollar-units) 17.330,08 2015*



84,0 2012


16,0 2012

* IMF estimative

2. Country


2014 2015

not available 0 %






2014 2015

Insured citizens 99,9 % 99,9 %

Uninsured citizens 0,1 % 0,1 %


2014 2015

Public insurance company 99,8 % 99,8 %

Private insurance company 0,1 % 0,1 %

Private co-payment 0,1 % 0,1 %



ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Cze

ch R

epu

blic



No restrictions




Not funded

No answer




practice


for practice


Device therapy ICD and PM Accreditation

Invasive electrophysiology EP Accreditation


Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiologist, licence for EP, licence for ablation

ICD or pacemaker implants Yes Cardiologist, licence for device implantation


Yes

Czech Society of Cardiology, Czech Heart Rhythm Association


Requires certain number of implantations



5. Pacemakers



Surgeons Yes 5 %


2014 2015







State Institute for Drug Control


Pacemaker 37

ICD implantation 17

CRT implantation 17




Percentage of academic centres among all practicing EP centres not available

Percentage of academic centres among all practicing implanting devices centres not available



Cze

ch R

epu

blic




2014 2015




Thereof, CRT ICD 1.456 1.487



Surgeons Yes 5 %



2014 2015



Thereof, Single chamber 1.588 1.475





8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons Yes 5 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 20 %


Official name

ICD Yes ICD online registry

Pacing Yes PM online registry

Electrophysiology Yes Catheter ablation online registry


Yes

State Institute for Drug Control


Official name: State Institute for Drug Control

Cze

ch R

epu

blic



Catheter ablation online registry



2014 2015














12. Guidelines


National Yes

U.S. No

European Yes


1 2 3 4 5

Lack of centres 6


1

Lack of referral 4



Lack of operators 2



13. Sources


Czech Society of Cardiology, Czech Heart Rhythm Association



Sales data

Estimation

ICD, PM and Catheter ablation registries

Den

mar

k


DENMARK


1. Statistics

Age pyramid for Denmark

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Den

mar

k









Population annual growth rate ( %) 0,2 2015









85,8 2012


14,2 2012

* IMF estimative

2. Country


2014 2015

not available 21 %



There is a tax financed public healthcare system.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Den

mar

k



No restrictions




Not funded

No answer

Comments: There are no restrictions for device implants, but only for ablation procedures.




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiologist with special training/education in invasive electrophysiology

ICD or pacemaker implants Yes Cardiologist with special training/education in device implantation


No



5. Pacemakers



Surgeons No 0 %


2014 2015







Danish Health Authority


Pacemaker 13

ICD implantation 6

CRT implantation 5




Pacemaker Yes








1 year

Den

mar

k




2014 2015







Surgeons No 0 %



2014 2015










Surgeons No 0 %

8. Loop recorders


2014 2015


Total loop recorders implanted not available not available



Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 15 %


Official name

ICD Yes Danish Pacemaker and ICD Register

Pacing Yes Danish Pacemaker and ICD Register

Electrophysiology Yes ablation.dk


Yes

Official name: “Regarding device recalls: Danish Pacemaker and ICD Registry; Regarding lead extractions: none”


Official name: Danish Health Authority; State Agency of Medicine

Den

mar

k



Official name: ablation.dk



2014 2015















1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators


12. Guidelines


National Yes

U.S. Yes

European Yes


13. Sources


Danish Society of Cardiology (DCS), DCS Working Group on Arrhythmia, Pacemaker and ICD



Official statistics – Danish Pacemaker and ICD Register, ablation.dk

Survey from professional association – Danish Society of Cardiology, Working Group on Arrhythmia, Pacemaker and ICD

Eg

ypt


EGYPT


1. Statistics

Age pyramid for Egypt

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1996*

40–64 years

2030

2015

1996*

20–39 years

2030

2015

1996*

< 20 years

2030

2015

1996*


Eg

ypt








Population 88.487.396 2015






Gross domestic product (U.S dollar-billions) not available 2015*

Gross domestic product per capita (U.S dollar-units) not available 2015*



39,0 2012


61,0 2012

* IMF estimative

2. Country


2014 2015




Egypt has a heterogeneous health system: there are different public / private providers and financing agents. The main agents are: the governmental sector (including ministry of health institutes, university and teaching hospitals, the military and police hospitals), the public sector (known as health insurance organization, the curative care organization) and finally the private sector.



2014 2015




2014 2015






ICD devices Yes

Pacemakers Yes

Ablation Yes

Comments: it depends on the insurance plan, in certain insurance plan the patient should pay certain percentage of the bill of whatever medical service he’s receiving



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Though the physicians receive reimbursement in governmental & university hospitals the reimbursements are quite insufficient

Eg

ypt



No restrictions




Not funded

No answer




practice


for practice


Device therapy EPS and Pacing Diploma of the ECRA


EPS and pacing Diploma of the ECRA


Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiologist/electrophysiologist, with the exception of one center, which is critical care unit, Cairo university, where critical care specialists are allowed to train in & perform EP & device implantation procedures

ICD or pacemaker implants

Yes Cardiologists or electrophysiologists, except in only one centre which is critical care unit, Cairo university where critical care specialists are allowed to train in & practice device therapy


Responsible person for quality control None


3 years


3 years


Pacemaker 28

ICD implantation 13

CRT implantation 13




Willingness to install quality control system No





No

Eg

ypt


5. Pacemakers



Surgeons No 0 %

Other Critical Care Physicians 0 %



Surgeons No 0 %

Other Critical Care Physicians, Cairo University 30 %


2014 2015








2014 2015






8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %




Surgeons No 0 %




Surgeons No 0 %

Other None 0 %



2014 2015







Replacements 24 29

Eg

ypt



10. Device specific



Official name

ICD No

Pacing No




No



2014 2015








Number of LAA closures 19 not available

Number of centres (LAA closures) 3 not available




15 4


13. Sources


Egyptian Society of Cardiology, Egyptian Cardiac Rhythm Association (ECRA)




Sales data

Estimation

12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators


Est

on

ia


ESTONIA


1. Statistics

Age pyramid for Estonia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Est

on

ia


















78,7 2012


21,3 2012

* IMF estimative

2. Country


2014 2015




Estonian health insurance relies on the principle of solidarity. The Health Insurance Fund covers the costs of health services required by the person in case of illness regardless of the amount of social tax paid for the person concerned. The Fund uses the social tax paid for the working population, also for covering the cost of health services provided to persons who have no income with regard to work activities. The employers are required by the law to pay social tax for all persons employed, whereby the rate of this tax is 33 % of the taxable amount, and of which 20 % is allocated for pension insurance and 13 % for health insurance.


Requirements for citizens to qualify for public insurance: An insured person is a permanent resident of the Republic of Estonia or a person living in Estonia by virtue of a temporary residence permit or by the right of permanent residence, who pays the social tax for himself/herself or for whom the payer of social tax is requi-red to pay social tax. Insured persons are: a person working on the basis of an employment contract; a public servant; a member of the management or supervisory board of a legal entity; a person employed on the basis of a contract under the law of obligations; a person registered at Estonian Unemployment Insurance Fund; a person, who participated in the elimination of the consequences of a nuclear disaster, a conscript, the non-working spouse of a diplomat or a public servant, the curator of a disabled person;, a person receiving child care allowance, a dependant spouse, for whom the government pays social tax, a person receiving social allowance. According to the Health Insurance Act persons for whom no social tax is paid are considered as having equal status to the insured person. The persons having equal status are: a pregnant woman, a person under 19 years of age, a person receiving state pension granted in Estonia, an insured person’s dependent spouse, who is no more than 5 years away from attaining the age limit for old-age pension, pupils (there are age limits), a student, who is permanent resident.


2014 2015

Insured citizens 95 % not available

Uninsured citizens 5 % not available


2014 2015

Public insurance company 100 % not available


Private co-payment 0 % not available

Possibility to subscribing to private health insurance plans No answer


ICD devices No

Pacemakers No

Ablation No

Est

on

ia



No restrictions




Not funded

No answer



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD




practice


for practice


Device therapy



Training centres





No

No answer



Specialist




No


100 implantations


100 implantations

Willingness to install quality control system No


Head of department of cardiology


Pacemaker 2

ICD implantation 2

CRT implantation 2







Est

on

ia


5. Pacemakers



Surgeons No 0 %


2014 2015








2014 2015







Surgeons No 0 %



2014 2015







Replacements 8 6


10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %





Official name

ICD No

Pacing No




Surgeons No 0 %

Est

on

ia




Yes

Official name: State Agency of Medicine




2014 2015













12. Guidelines


National No

U.S. No

European Yes



1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators


13. Sources


Estonian Society of Cardiology, Working Group of Arrhythmias




Fin

lan

d


FINLAND


1. Statistics

Age pyramid for Finland

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Fin

lan

d


















75,0 2012


25,0 2012

* IMF estimative

2. Country


2014 2015

39 % 23 %



Finland has a compulsory health care system which is tax based. It provides comprehensive coverage for the entire population. The Ministry of Social Affairs and Health issues the legislation on health and social care policies and monitors the implementation. At local level, the municipal health committee and council make decisions on the planning and organization of healthcare.



2014 2015




2014 2015

Public insurance company 75,2 % 75,6 %


Private co-payment 21,8 % 21,4 %



ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: “The physicians do not receive any additional reimbursement for any procedures performed in the public health care hospitals.”; “The hospital charge the municipalities for services according to annually set prices. Billing is usually based on DRG, but per procedure billing is used by some hospitals.”

Fin

lan

d



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist




No




5. Pacemakers



Surgeons Yes 5 %


2014 2015


Total Pacemaker units implanted 5.536* 5.821


First implants 4.253* 4.578

Replacements 1.283* 1.243

*CRT-P included


National Supervisory Authority for Welfare and Health


Pacemaker 20

ICD implantation 19

CRT implantation 15




Pacemaker Yes







Fin

lan

d




2014 2015







Surgeons No 0 %



2014 2015










Surgeons Yes 5 %

8. Loop recorders


2014 2015





Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 0 %


Official name

ICD No

Pacing No



Yes

Official name: National Supervisory Authority for Welfare and Health (Valvira)


Official name: National Supervisory Authority for Welfare and Health (Valvira)

Fin

lan

d





2014 2015













12. Guidelines


National Yes

U.S. No

European Yes


1 2 3 4 5

Lack of centres 5


6

Lack of referral 1



Lack of operators 3



13. Sources


The Finnish Cardiac Society, National Working Group for Arrhythmias and Pacing



Official statistics – Statistics Finland, Ministry of Social Affairs and Health

Survey from professional association – Finnish Cardiac Society Estimation

Fran

ce


FRANCE


1. Statistics

Age pyramid for France

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Fran

ce








Population 66.553.766 2015






Gross domestic product (U.S dollar-billions) 2.422,65 2015*




77,4 2012


22,6 2012

* IMF estimative

2. Country


2014 2015

26 % 22,6 %*

* 2011-2013 data



Sécurité sociale: French National Health System



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: This reimbursement only concerns private hospitals. There is no physician reimbursement in public hospitals unless the activity is performed during private practice.

Fran

ce



No restrictions




Not funded

No answer




practice


for practice


Device therapy Diplôme Inter Universitaire (DIU) de rythmologie et de stimulation cardiaque


DIU de rythmologie et de stimulation cardiaque


Training centres


Specialist

Catheter ablation Yes Cardiologist with dedicated certification

ICD or pacemaker implants Yes Cardiologist with dedicated certification


Yes

Official name: Cardiac Rhythm and Pacing Group of the French Society of Cardiology





No

No answer


5. Pacemakers



Surgeons Yes 10 %


2014 2015




First implants 55.000 not available



2 years




The HAS (Haute Autorité de Santé) agency











Fran

ce




2014 2015



Thereof, CRT pacemaker 3.500 3.888




Surgeons No 0 %



2014 2015










Surgeons Yes 5 %


10. Device specific


8. Loop recorders


2014 2015


Total loop recorders implanted not available 3.600

9. Lead extractions


2014 2015


Total lead extraction procedures 2.200 3.000



Surgeons No 0 %



Surgeons Yes 10 %


Official name

ICD No

Pacing No



No


Official name: Agence Nationale de Sécurité des Médicaments et des Porduits de santé

Fran

ce





2014 2015






Number of VT/VF ablations not available 741








12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Official name: Groupe de Rythmologie et de Stimulation de la Société Française de Cardiologie



Official statistics


Sales data

Estimation

Geo

rgia


GEORGIA


1. Statistics

Age pyramid for Georgia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Geo

rgia


















18,0 2012


82,0 2012

* IMF estimative

2. Country


2014 2015

38 not available



National Health System and private insurance


Requirements for citizens to qualify for public insurance: Every citizen has basic insurance


2014 2015

Insured citizens not available not available

Uninsured citizens not available not available


2014 2015

Public insurance company not available not available





ICD devices Yes

Pacemakers Yes

Ablation Yes



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Reimbursement is only for the retired people, the population living below poverty level and some target groups (e.g. students, etc.)

Geo

rgia



No restrictions




Not funded

No answer



Yes, it´s required for practice


for practice

No No answer

Official name

Device therapy Subspecialty “Cardiac electrophysiology and the management of arrhythmias”


Subspecialty “Cardiac electrophysiology and the management of arrhythmias”


Training centres Accreditation for training in subspe-cialty “Cardiac electrophysiology and the management of arrhythmias”





No

No answer



Specialist

Catheter ablation Yes Cardiac electrophysiologist

ICD or pacemaker implants Yes Cardiac electrophysiologist or cardiac surgeon


No





Hospitals


Pacemaker 1

ICD implantation 1

CRT implantation 1







Geo

rgia


5. Pacemakers



Surgeons Yes 10 %


2014 2015








2014 2015







Surgeons No 0 %



2014 2015







Replacements 4 5


10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %





Official name

ICD No

Pacing No




Surgeons No 0 %

Geo

rgia




No




2014 2015













1 not available

12. Guidelines


National No

U.S. Yes

European Yes



1 2 3 4 5

Lack of centres 6


1

Lack of referral 5



Lack of operators 3


13. Sources


Georgian Heart Rhythm Association



Georgian Heart Rhythm Association

Ger

man

y


GERMANY


1. Statistics

Age pyramid for Germany

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Ger

man

y








Population 80.854.408 2015










76,7 2012


23,3 2012

* IMF estimative

2. Country


2014 2015

40 % 44,7 %



public insurance full cover, in addition private insurance companies


Requirements for citizens to qualify for public insurance: general coverage


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Ger

man

y



No restrictions




Not funded

No answer






No

No answer


Yes, it´s required for practice


for practice

No No answer

Official name

Device therapy Sachkunde Device-Therapie, Curriculum Aktive Rhythmusimplantate


Curriculum Elektrophysiologie


Training centres


Specialist


ICD or pacemaker implants Yes Cardiologist, cardiac or thora-cic surgeon, internal medicine



No



18 months


AQUA institute


Pacemaker 136

ICD implantation 136

CRT implantation 136

Electrophysiological studies and cathether ablation 108



Pacemaker Yes



Cathether ablation No




Ger

man

y


5. Pacemakers



Surgeons Yes 28 %

Other Internal Medicine 12 %


2014 2015

Implanting centres 980 1.135







2014 2015







Surgeons Yes 20 %

Other Internal Medicine 12 %


8. Loop recorders


2014 2015

Implanting centres not available 843

Total loop recorders implanted not available 16.900

9. Lead extractions


2014 2015


Total lead extraction procedures 4.963 2.357



Surgeons Yes 2 %

Other Neurologist 6 %



Surgeons Yes 83 %



Surgeons Yes 21 %

Other: Internal Medicine 12 %



2014 2015




Thereof, Dual chamber 6.365 10.673




Ger

man

y


10. Device specific



Official name

ICD No

Pacing Yes German pacemaker Registry




No


Official name: AQUA



2014 2015






Number of VT/VF ablations not available 6.686


Number of LAA closures 3.500 4.428








1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators


13. Sources


German Cardiac Society, Working Group on Arrhythmias



Deutscher Herzbericht, AQUA, Statistisches Bundesamt

Sales data

Estimation

12. Guidelines


National Yes

U.S. Yes

European Yes

Gre

ece


GREECE


1. Statistics

Age pyramid for Greece

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Gre

ece








Population 10.775.643 2015










67,1 2012


32,9 2012

* IMF estimative

2. Country


2014 2015




The Greek healthcare system is characterized by the coexistence of NHS, a compulsory social insurance and a voluntary private health insurance system. The NHS provides universal coverage to the population and offers equal access to health services for all and social cohesion.


Requirements for citizens to qualify for public insurance: Citizens have to pay yearly their contribution to the public insurance system.


2014 2015




2014 2015






ICD devices No answer

Pacemakers No answer

Ablation No answer



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Gre

ece



No restrictions




Not funded

No answer




practice


for practice


Device therapy Certification from a Comitee for Pacing and Electrophysiology of the Ministry of Health


Certification from a Comitee for Pacing and Electrophysiology of the Ministry of Health


Training centres Certification from a Comitee for Pacing and Electrophysiology of the Ministry of Health





No

No answer



Specialist




No


1 year


1 year


Responsible person for quality control None


Pacemaker 15

ICD implantation 8

CRT implantation 8







Gre

ece


5. Pacemakers



Surgeons Yes 3 %


2014 2015








2014 2015







Surgeons Yes 2 %



2014 2015









8. Loop recorders


2014 2015



9. Lead extractions

Lead extractions procedures and number of centers that performed lead extractions

2014 2015





Surgeons No 0 %



Surgeons Yes 10 %



Surgeons Yes 2 %

Gre

ece


10. Device specific


Official name

ICD Yes Working Group of Electrophysiology and Pacing of Greek Society of Cardiology Registry

Pacing Yes Working Group of Electrophysiology and Pacing of Greek Society of Cardiology Registry

Electrophysiology Yes Working Group of Electrophysiology and Pacing of Greek Society of Cardiology Registry


No




2014 2015













not available 8


Reasons why remote monitoring is not available: Reasons related to cost



1 2 3 4 5

Lack of centres 5


1

Lack of referral 2



Lack of operators 4


13. Sources


Working Group of Electrophysiology and Pacing of Greek Society of Cardiology




Sales data

Estimation

Working Group of Electrophysiology and Pacing of Greek Society of Cardiology

12. Guidelines


National No

U.S. No

European Yes


Official name: Working Group of Electrophysiology and Pacing of Greek Society of Cardiology Registry

Hu

ng

ary


HUNGARY


1. Statistics

Age pyramid for Hungary

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Hu

ng

ary


















62,6 2012


37,4 2012

* IMF estimative

2. Country


2014 2015

not available 46 %



The Hungarian healthcare system is organised through a National Health Insurance Fund which is available for all citizens registered at the Fund.


Requirements for citizens to qualify for public insurance: Age under 18 or retired; or valid job contract; or regular payment of the insurance fee.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Hu

ng

ary



No restrictions




Not funded

No answer




practice


for practice


Device therapy Arrhythmologist Licence for Pacemaker/ICD/CRT (Device Therapy)

Invasive electrophysiology Arrhythmologist Licence for Cardiac Electrophysiology and Ablation

Allied professionals Arrhythmologist Licence for Pacemaker/ICD/CRT (Device Therapy) for Allied Professionals

Training centres


Specialist

Catheter ablation Yes Cardiologist, cardiologist fellow

ICD or pacemaker implants Yes Cardiologist, cardiologist fellow, heart surgeon, anaesthesiologist





No

No answer



Responsible person for quality control No answer


Pacemaker 6

ICD implantation 6

CRT implantation 6








Yes

Hungarian Society of Cardiology



2 years

Hu

ng

ary


5. Pacemakers



Surgeons Yes 5 %


2014 2015



Thereof, Leadless Pacemaker 32 24





2014 2015


Total CRT units implanted 941 1.091





Surgeons Yes 3 %



2014 2015





Thereof, Subcutaneous ICD 0 3




10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons Yes 5 %


Official name

ICD Yes Hungarian Online Pacemaker Registry

Pacing Yes Hungarian Online Pacemaker Registry




Surgeons Yes 3 %

Hu

ng

ary




Yes

Official name: National Health Insurance Fund


Official name: Hungarian Online Pacemaker Registry and individual paper based data collection from centers



2014 2015












Number of physicians under training to become independent electrophysiologists 15 not available

12. Guidelines


National Yes

U.S. No answer

European Yes



1 2 3 4 5

Lack of centres 6


4

Lack of referral 1



Lack of operators 5


13. Sources


Working Group on Cardiac Arrhythmias and Pacing, Hungarian Society of Cardiology



Official statistics – National Health Insurance Fund

Survey from professional association - Working Group on Cardiac Arrhythmias and Pacing, Hungarian Society of Cardiology

Icel

and


ICELAND


1. Statistics

Age pyramid for Iceland

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1994*

40–64 years

2030

2015

1994*

20–39 years

2030

2015

1994*

< 20 years

2030

2015

1994*


Icel

and








Population 331.918 2015










80,5 2012


19,5 2012

* IMF estimative

2. Country


2014 2015

45 % 36 %



National Health System with universal access


Requirements for citizens to qualify for public insurance: Permanent residency


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: For atrial fibrillation ablations only

Icel

and



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist


ICD or pacemaker implants Yes Cardiologist/Cardiac Surgeon


No


5. Pacemakers



Surgeons Yes 50 %


2014 2015





Replacements 41 45




Responsible person for quality control No answer


Pacemaker 0

ICD implantation 0

CRT implantation 0







Icel

and




2014 2015







Surgeons No 0 %



2014 2015







Replacements 4 19



Surgeons Yes 50 %


10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons No 0 %


Official name

ICD No

Pacing No



No


Icel

and





2014 2015













12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 4


1

Lack of referral 2



Lack of operators 6



13. Sources


Icelandic Society of Cardiology



Official statistics

Irel

and


IRELAND


1. Statistics

Age pyramid for Ireland

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1996*

40–64 years

2030

2015

1996*

20–39 years

2030

2015

1996*

< 20 years

2030

2015

1996*


Irel

and


















67,6 2012


32,4 2012

* IMF estimative

2. Country


2014 2015

not available 0,19 %



Health Services Executive


Requirements for citizens to qualify for public insurance: Under the Health act 1970, everyone who is ordinary resident in Ireland qualifies for hosptial care


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: In the public health system all the above procedures are covered with no additional incentive or reimbursemenet for salaried physicians. In the private insurance system all the above are covered with physician reimbursement.

Irel

and



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiac electrophysiologist

ICD or pacemaker implants Yes Cardiac electrophysiologist


No


6 years


6 years


5. Pacemakers



Surgeons No 0 %


2014 2015


Total Pacemaker units implanted not available 2.277





HIQA


Pacemaker 10

ICD implantation 10

CRT implantation 10








Irel

and




2014 2015


Total CRT units implanted not available 319

Thereof, CRT pacemaker not available 88

Thereof, CRT ICD not available 231



Surgeons No 0 %



2014 2015


Total ICD units implanted not available not available

Thereof, Single chamber not available 403

Thereof, Dual chamber not available 337




8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 50 %


Official name

ICD Yes G-pace / Heart Rhythm Ireland but not 100 % participation

Pacing Yes G-pace / Heart Rhythm Ireland but not 100 % participation



Yes

Official name: Irish Medicines Board

Availability of a national quality insurance system or complication registry No answer

Irel

and





2014 2015


Number of ablations performed not available not available


Number of AF ablations not available 650

Number of ablation centres (> 50 AF ablations) not available not available









12. Guidelines


National No answer

U.S. Yes

European No answer


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


EP Subgroup of Irish Cardiac Society



Central Statistics Office, Health Insurance Authority Report

Department of Health, Department of Finance

Industry

Isra

el


ISRAEL


1. Statistics

Age pyramid for Israel

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Isra

el


















59,8 2012


40,2 2012

* IMF estimative

2. Country


2014 2015

not available 17 %



National Health System (National Insurance) with private sector supplements



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Isra

el



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Electrophysiologist



No




5. Pacemakers



Surgeons Yes 2 %


2014 2015







The ministry of Health


Pacemaker 1

ICD implantation 1

CRT implantation 1








Isra

el




2014 2015







Surgeons No 0 %



2014 2015







Replacements 420 not available



Surgeons No 0 %


10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons Yes 1 %


Official name

ICD Yes Israeli ICD Registry

Pacing No



No


Isra

el





2014 2015




Number of AF ablations 550 not available









1 2

12. Guidelines


National Yes

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


The Israeli Working Group on Pacing and Electrophysiology, Israeli Heart Society



Official statistics

Sales data

Estimation

Ital

y


ITALY


1. Statistics

Age pyramid for Italy

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Ital

y








Population 61.855.120 2015










77,3 2012


22,7 2012

* IMF estimative

2. Country


2014 2015




National health care system with the possibility of private insurance


Requirements for citizens to qualify for public insurance: to be Italian citizen


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: We have no dedicated reimbursement for leadless pacing and S-ICD. The reimbursement for leadless pacing is the same for single chamber pacemaker replacement. The reimbursement for S-ICD is the same for single chamber ICD.

Ital

y



No restrictions




Not funded

No answer




practice


for practice


Device therapy AIAC (italian heart rhythm association) certification for

cardiac pacing

invasive electrophysiology AIAC (italian heart rhythm association)certification for

electrophysiology

allied professionals EHRA certification for ap

training centres





No

No answer


Specialist




No





Not applicable












5. Pacemakers



Surgeons No 0 %


2014 2015






Ital

y




2014 2015







Surgeons No 0 %



2014 2015










Surgeons No 0 %

8. Loop recorders


2014 2015


Total loop recorders implanted 3.900 4.000



Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons No 0 %


Official name

ICD Yes RIP & RID

Pacing Yes RIP & RID



Yes

Official name: AIAC


Ital

y





2014 2015

Number of ablation centres not available not available



Number of AF ablations not available not available










12. Guidelines


National Yes

U.S. No

European Yes


1 2 3 4 5

Lack of centres 6


1

Lack of referral 3



Lack of operators 5



13. Sources


AIAC – Associazione Italiana Aritmologia E Cardiostimolazione (Italian Heart Rhythm Association)


EHRA White Book 2015Survey from professional associationSales dataEstimation

Kaz

akh

stan


KAZAKHSTAN


1. Statistics

Age pyramid for Kazakhstan

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Kaz

akh

stan








Population 18.157.122 2015










55,8 2012


44,2 2012

* IMF estimative

2. Country


2014 2015

23,5 % 26 %






2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Kaz

akh

stan



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Interventional cardiologist

ICD or pacemaker implants Yes Interventional cardiologist or cardiac surgeon


No



1 year


5. Pacemakers





2014 2015







Medical and Pharmaceutical activity Control Committee


Pacemaker 2

ICD implantation 2

CRT implantation 2







Pacemaker Yes




Kaz

akh

stan




2014 2015










2014 2015








8. Loop recorders


2014 2015





Surgeons No 0 %





10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 0 %


Official name

ICD No

Pacing No



No


Medical and Pharmaceutical Activity Control Committee

Kaz

akh

stan





2014 2015














12. Guidelines


National No answer

U.S. No

European Yes


1 2 3 4 5

Lack of centres 6


2

Lack of referral 4



Lack of operators 1



13. Sources


Association of cardiologists of Kazakhstan, Kazakh Association of arrhythmologists



Official statistics


Ko

sovo


KOSOVO


1. Statistics

Age pyramid for Kosovo

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Ko

sovo















Gross domestic product per capita (U.S dollar-units) not available not available






* IMF estimative

2. Country


2014 2015




Health care system in Kosovo is organized in three sectors including: primary, secondary and tertiary health care. The highest health care authority in Kosovo is Ministry of Health of Kosovo.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Ko

sovo



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist




No

Required period of training to perform implantations No answer



5. Pacemakers




Other not available


2014 2015





Replacements 7 6



University clinical center of Kosovo Clinic of Cardiology


Pacemaker 5

ICD implantation 3







Percentage of academic centres among all practicing implanting devices centres

not available

Ko

sovo




2014 2015



Thereof, CRT pacemaker 0 not available





Other Technical consultant 20 %



2014 2015











Other not available


10. Device specific


Reasons why remote monitoring is not available: We do not have such a device.

8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %




Other not available


Official name

ICD No

Pacing No



No


Ko

sovo





2014 2015


Number of ablations performed 0 not available









Number of electrophysiologists performed catheter ablation independently 0 not available


0 not available

12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 1


4

Lack of referral 5



Lack of operators 3



13. Sources


Kosovo Society of Cardiology



Kyr

gyz

stan


KYRGYZSTAN


1. Statistics

Age pyramid for Kyrgyzstan

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Kyr

gyz

stan


















60,2 2012


39,8 2012

* IMF estimative

2. Country


2014 2015

50 % 50 %





Requirements for citizens to qualify for public insurance:– pensioners at age 70 years and older– labouring people– children at age 5 years and less– invalids at 2nd and 1st groups


2014 2015




2014 2015






ICD devices Yes

Pacemakers Yes

Ablation Yes

Comments: Yes, not only in the private sector, at public hospitals too.



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Kyr

gyz

stan



No restrictions




Not funded

No answer




practice


for practice


Device therapy


Allied professionals Certification commission of Healthcare Ministry

Training centres Certification commission of Healthcare Ministry





No

No answer


Specialist

Catheter ablation Yes Cardiosurgeon

ICD or pacemaker implants Yes Cardiosurgeon


No answer


5. Pacemakers





2014 2015


Total Pacemaker units implanted 126 not available








Healthcare Ministry


Pacemaker 2

ICD implantation 2

CRT implantation 1







Kyr

gyz

stan




2014 2015


Total CRT units implanted 0 not available

Thereof, CRT pacemaker 0 not available

Thereof, CRT ICD 0 not available






2014 2015


Total ICD units implanted 0 not available

Thereof, Single chamber 0 not available

Thereof, Dual chamber 0 not available


First implants 0 not available







10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015










Official name

ICD No answer

Pacing No answer



No answer

Kyr

gyz

stan


Availability of a national registry for interventional electrophysiology No answer



2014 2015














12. Guidelines


National No answer

U.S. No answer

European No answer


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Kyrgyz Society of Cardiology



Official statistics

Estimation

Other

Latv

ia


LATVIA


1. Statistics

Age pyramid for Latvia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Latv

ia


















60,6 2012


36,7 2012

* IMF estimative

2. Country


2014 2015

53,4 % 53,1 %






2014 2015




2014 2015






ICD devices Yes

Pacemakers Yes

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Latv

ia



No restrictions




Not funded

No answer




practice


for practice


Device therapy Latvian National Society of Cardiology

Invasive electrophysiology Latvian National Society of Cardiology

Allied professionals Latvian National Society of Cardiology

Training centres Latvian National Society of Cardiology





No

No answer


Specialist




Yes

Latvian National Society of Cardiology



1 year


1 year


National Healthcare System


Pacemaker 1

ICD implantation 1

CRT implantation 1




Pacemaker Yes







Latv

ia


5. Pacemakers



Surgeons Yes 30 %


2014 2015








2014 2015







Surgeons Yes 30 %




Surgeons Yes 30 %

8. Loop recorders


2014 2015





Surgeons Yes 30 %

9. Lead extractions


2014 2015





Surgeons Yes 100 %



2014 2015







Replacements 8 8

Latv

ia


10. Device specific



Official name

ICD Yes National register of Implantable Devices and EP procedures, National WG of Arrhythmology

Pacing Yes National register of Implantable Devices and EP procedures

Electrophysiology Yes National register of Implantable Devices and EP procedures


Yes

Official name: National Healthcare system in collaboration with National Society of Cardiology


Official name: National Healthcare system in collaboration with National Society of Cardiology


Official name: National Register of Implantable Devices and EP procedures



2014 2015













2 2


12. Guidelines


National Yes

U.S. No answer

European Yes


1 2 3 4 5

Lack of centres 5


1

Lack of referral 3



Lack of operators 4


13. Sources


Latvian National Society of Cardiology, National Working Group of Arrhythmology



National Healthcare System

Latvian National Society of Cardiology

National register of Implantable Devices and EP procedures

Lith

uan

ia


LITHUANIA


1. Statistics

Age pyramid for Lithuania

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Lith

uan

ia


















65,3 2012


31,1 2012

* IMF estimative

2. Country


2014 2015




Provision of health services is regulated by National Health Insurance Fund under the Ministry of Health.


Requirements for citizens to qualify for public insurance: Permanent residents and officially employed, non-permanent residents have basic insurance.


2014 2015

Insured citizens not available 100 %

Uninsured citizens not available 0 %


2014 2015

Public insurance company not available 98 %

Private insurance company not available 2 %

Private co-payment not available 0 %



ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Leadless pacing and subcutaneous ICDs not reimbursed.

Lith

uan

ia



No restrictions




Not funded

No answer




practice


for practice


Device therapy State Healthcare Accreditation Agency

Invasive electrophysiology State Healthcare Accreditation Agency

Allied professionals State Healthcare Accreditation Agency

Training centres State Healthcare Accreditation Agency





No

No answer


Specialist


ICD or pacemaker implants Yes Cardiologist, cardiac surgeon


No


5. Pacemakers



Surgeons Yes 1 %


2014 2015









State Healthcare Accreditation Agency


Pacemaker 2

ICD implantation 2

CRT implantation 2




Pacemaker Yes







Lith

uan

ia




2014 2015







Surgeons No 0 %



2014 2015







Replacements 37 39



Surgeons No 0 %



Official name: State Healthcare Accreditation Agency

10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons Yes 5 %


Official name

ICD No

Pacing No



Yes

Official name: State Healthcare Accreditation Agency

Lith

uan

ia





2014 2015


Number of ablations performed 885 1.078











12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 4


1

Lack of referral 5



Lack of operators 2



13. Sources


Lithuanian Society of Cardiology, Working Group on Pacing and Electrophysiology



Sample short survey

Luxe

mb

ou

rg


LUXEMBOURG


1. Statistics

Age pyramid for Luxembourg

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Luxe

mb

ou

rg


















83,5 2012


16,5 2012

* IMF estimative

2. Country


2014 2015






Requirements for citizens to qualify for public insurance:Payed half by yourself and half by your employer.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Luxe

mb

ou

rg



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Trained Cardiologist

ICD or pacemaker implants Yes Trained Cardiologist


No




5. Pacemakers



Surgeons Yes 15 %


2014 2015





Replacements 82 112


No official quality control


Pacemaker 0

ICD implantation 0

CRT implantation 0








Luxe

mb

ou

rg




2014 2015







Surgeons Yes 10 %



2014 2015







Replacements 17 18

8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons Yes 2 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 100 %


Official name

ICD Yes INCCI (Institut National de Chirurgie Cardiaque et de Cardiologie Invasive)

Pacing No

Electrophysiology Yes INCCI (Institut National de Chirurgie Cardiaque et de Cardiologie Invasive)


Yes

Official name: Ministry of Health


Luxe

mb

ou

rg



Official name: INCCI (Institut National de Chirurgie Cardiaque et de Cardiologie Invasive)



2014 2015













0 0

12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 6


5

Lack of referral 2



Lack of operators 4



13. Sources


Société Luxembourgeoise de Cardiologie



Official statistics - INCCI / Ministry of Health

Survey from professional association - Société Luxembourgeoise de Cardiologie

Mac

edo

nia

FY

R


MACEDONIA FYR


1. Statistics

Age pyramid for Macedonia FYR

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1994*

40–64 years

2030

2015

1994*

20–39 years

2030

2015

1994*

< 20 years

2030

2015

1994*


Mac

edo

nia

FY

R


















65,3 2012


34,7 2012

* IMF estimative

2. Country


2014 2015

52 % 58 %



National Health System The health care system in the Republic of Macedonia is organized on three levels: primary, secondary and tertiary level. The health care is delivered at: health stations, health centers, general and specialized hospitals, clinical hospitals, university clinics and institutes, University Dental Clinical Centre, Maxillofacial Surgery Clinic, Institute of Transfusion Medicine, Institute of Public Health, and 10 centers for public health.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No

Comments: Yes, only in private sector



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Mac

edo

nia

FY

R



No restrictions




Not funded

No answer




practice


for practice


Device therapy


Allied professionals Univ St Kliment Ohridski Bitola (http://www.vmsb.uklo.edu.mk/)

Training centres





No

No answer


Specialist




No


5. Pacemakers



Surgeons No 0%


2014 2015





Replacements 60 83




Institution where the procedures are performed


Pacemaker 1

ICD implantation 1

CRT implantation 1








Mac

edo

nia

FY

R




2014 2015







Surgeons No 0%



2014 2015






First implants 9 20

Replacements 2 9



Surgeons No 0%



10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0%



Surgeons Yes 50 %


Official name

ICD No

Pacing No



No

Mac

edo

nia

FY

R





2014 2015













12. Guidelines


National No answer

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Macedonian Society for Cardiology



Official statistics


Estimation

Other

Mal

ta


MALTA



1. Statistics

Age pyramid for Malta

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1996*

40–64 years

2030

2015

1996*

20–39 years

2030

2015

1996*

< 20 years

2030

2015

1996*


Mal

ta


2. Country


2014 2015

40 % not available

















65,6 2012


34,4 2012

* IMF estimative



It‘s a National Health System completely funded by a National Public Health Insurance


Requirements for citizens to qualify for public insurance: Being a Maltese citizen or taxpayer/wife and children of a taxpayer.


2014 2015


Uninsured citizens 0% 0%


2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Mal

ta



No restrictions




Not funded

No answer




practice


for practice


Device therapy EHRA certification

Invasive electrophysiology EHRA certification

Allied professionals EHRA certification

Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiologist trained in electrophysiology



No



2 years


5. Pacemakers



Surgeons No 0 %


2014 2015








Hospital administration and health department


Pacemaker 1

ICD implantation 1

CRT implantation 1







Mal

ta




2014 2015







Surgeons No 0 %



2014 2015







Replacements 10 9



Surgeons No 0 %

8. Loop recorders


2014 2015





Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons No 0 %


Official name

ICD No

Pacing No



No


Mal

ta





2014 2015













12. Guidelines


National No answer

U.S. No

European Yes


1 2 3 4 5

Lack of centres 6


1

Lack of referral 2



Lack of operators 5



13. Sources


Maltese Cardiac Society



Official statistics


Mo

nte

neg

ro


MONTENEGRO


1. Statistics

Age pyramid for Montenegro

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1992*

40–64 years

2030

2015

1992*

20–39 years

2030

2015

1992*

< 20 years

2030

2015

1992*


Mo

nte

neg

ro


















61,7 2012


38,3 2012

* IMF estimative

2. Country


2014 2015

54 % 54 %



Healthcare system is organized through NHS Fund.


Requirements for citizens to qualify for public insurance: Every citizen who pay the public basic insurance have completely health protection


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Mo

nte

neg

ro



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist




No



6 months


5. Pacemakers



Surgeons Yes 30 %


2014 2015





Replacements 32 50



The professionals from different medical fields


Pacemaker 1

ICD implantation 1

CRT implantation 1







Mo

nte

neg

ro




2014 2015







Surgeons No 0 %



2014 2015







Replacements 6 7



Surgeons Yes 50 %


10. Device specific


Reasons why remote monitoring is not available: We do not have the technical possibility for remote monitoring of devices

8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons Yes 50 %



Surgeons Yes 50 %


Official name

ICD No

Pacing No



No


Mo

nte

neg

ro





2014 2015













12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 1


2

Lack of referral 3



Lack of operators 4

Others: Limited financial resources



13. Sources


Center for pacemaker and electrophysiology



Sample short survey

Mo

rocc

o


MOROCCO


1. Statistics

Age pyramid for Morocco

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Mo

rocc

o








Population 33.322.699 2015










35,5 2012


64,5 2012

* IMF estimative

2. Country


2014 2015

40 % 37,6%






2014 2015




2014 2015






ICD devices Yes

Pacemakers Yes

Ablation Yes



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Physicians: only on private practice

Mo

rocc

o



No restrictions




Not funded

No answer

Comments: National health budget




practice


for practice


Device therapy DEU for cardiac pacing


DEU of invasive electrophysiology


Training centres





No

No answer

Comments: European DEU


Specialist


ICD or pacemaker implants Yes Cardiologist and cardiac surgeon


No


5. Pacemakers



Surgeons Yes 1 %


2014 2015




First implants not available 1.801



Health Ministry


Pacemaker 11

ICD implantation 7

CRT implantation 7









1 year minimum


1 year minimum

Mo

rocc

o




2014 2015







Surgeons Yes 1 %



2014 2015













10. Device specific


Reasons why remote monitoring is not available: infrastructure

8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons Yes 1 %


Official name

ICD No answer

Pacing Yes SMC

Electrophysiology Yes SMC


No

Mo

rocc

o



Official name: SMC



2014 2015














12. Guidelines


National Yes

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres 1


2

Lack of referral 6



Lack of operators 5



13. Sources


SMC



Official statistics


Sales data

Estimation

Net

her

lan

ds


NETHERLANDS


1. Statistics

Age pyramid for Netherlands

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1995*

40–64 years

2030

2015

1995*

20–39 years

2030

2015

1995*

< 20 years

2030

2015

1995*


Net

her

lan

ds








Population 16.947.904 2015










79,6 2012


13,2 2012

* IMF estimative

2. Country


2014 2015

33 % 28 %



There is a system of obligatory helath Insurance, with private Insurance companies. These Insurance companies are obliged to provide a package with a defined set of insured treatments.


Requirements for citizens to qualify for public insurance: resident in the Netherlands


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: The hospital receives the total amount of reimbursement of the Insurance companies. Physicians recieve from the hospital a honorarium for each procedure done.

Net

her

lan

ds



No restrictions




Not funded

No answer

Comments: In some rare cases the Dutch guidelines are somewhat different from the ESC guidelines.



Yes, it´s required

for practice


for practice


Device therapy EHRA or IHBRE certification

Invasive electrophysiology EHRA certification; at this time the Dutch guidelines to become an electrophysiologist are rewritten

Allied professionals EHRA certification; at this time the Dutch guidelines are rewritten

Training centres NVVC practice guidelines and NHRA educational document for invasive electrophysiology; at this time these guidelines are rewritten





No

No answer



Yes

NHRA (in name of the NVVC: Nederlands Vereniging voor Cardiologie)


at least 1 year


2 years


Specialist

Catheter ablation Yes Cardiologistis named in the NHRA (Netherlands Heart Rhythm Association) documents

ICD or pacemaker implants YesCardiologistis named in the NHRA (Netherlands

Heart Rhythm Association) documents


NCDR: National Cardiovascular Data Registry


Pacemaker 16

ICD implantation 16

CRT implantation 16




Pacemaker Yes







Net

her

lan

ds


5. Pacemakers



Surgeons Yes 2 %

Other: allied professionals 3 %


2014 2015


Total Pacemaker units implanted 10.132 10.000*


First implants 7.467 7.600*

Replacements 2.665 2.350*

* Leadless Pacemaker included



2014 2015







Surgeons Yes 3 %




2014 2015


Total ICD units implanted 3.577 3.500*




First implants 2.373 2.300*

Replacements 1.204 1.050*

* Subcutaneous ICD included



Surgeons Yes 3 %




Surgeons Yes 5 %


8. Loop recorders


2014 2015


Total loop recorders implanted 1.500 300

9. Lead extractions


2014 2015





Surgeons Yes 10 %

Net

her

lan

ds


10. Device specific



Official name

ICD Yes NCDR (National Cardiovascular Data Registry, DIPR (Dutch ICD en Pacemaker Registry)

Pacing Yes NCDR and DIPR

Electrophysiology Yes NCDR and NHRA registry


Yes

Official name: Device Comittee from the NHRA


NCDR




2014 2015













12 10


12. Guidelines


National Yes

U.S. No

European Yes


1 2 3 4 5

Lack of centres 5


1

Lack of referral 2



Lack of operators 6


13. Sources


Netherlands Heart Rhythm Association


EHRA White Book 2015Official statistics Survey from professional association Estimation Other

No

rway


NORWAY


1. Statistics

Age pyramid for Norway

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


No

rway


















85,0 2012


15,0 2012

* IMF estimative

2. Country


2014 2015




National Health Systems


Requirements for citizens to qualify for public insurance: Norwegian citizen


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

No

rway



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist




No


5. Pacemakers


Cardiologists Yes 99,7 %

Surgeons No 0,3 %


2014 2015







National Health register


Pacemaker 5

ICD implantation 5

CRT implantation 4










No

rway




2014 2015







Surgeons No 0 %



2014 2015



Thereof, Single chamber 298 222*

Thereof, Dual chamber 836 696*




*First implants only



Surgeons No 0 %



10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons No 0 %


Official name

ICD Yes Norwegian Pacemaker- and ICD registry

Pacing Yes Norwegian Pacemaker- and ICD registry



No

No

rway



12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres 5


6

Lack of referral 2



Lack of operators 3




2014 2015













2 2


13. Sources


Norwegian Society of Cardiology, Working group of arrhythmias



Official statistics


Po

lan

d


POLAND


1. Statistics

Age pyramid for Poland

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Po

lan

d








Population 38.562.189 2015










69,2 2012


30,3 2012

* IMF estimative

2. Country


2014 2015

46 % 45 %





Requirements for citizens to qualify for public insurance: Monthly health care contribution


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: In the case of reimbursement for IRL and S-ICD implantation decision may be taken individually by the NHS at the request of the hospital. Reimbersement for leadless pacing is at the level of a standard pacemaker

Po

lan

d



No restrictions




Not funded

No answer



Yes, it´s required

for practice


for practice


Device therapy Certification of Heart Rhythm Section of Polish Cardiac Society

Invasive electrophysiology Certification of Heart Rhythm Section of Polish Cardiac Society


Training centres





No

No answer


Specialist




No




5. Pacemakers



Surgeons Yes 1 %


2014 2015







Ministry of Health


Pacemaker 41

ICD implantation 26

CRT implantation 12








Po

lan

d




2014 2015







Surgeons No 0 %



2014 2015








8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons No 1 %


10. Device specific


9. Lead extractions


2014 2015


Total lead extraction procedures 600 1.050



Surgeons No 1 %


Official name

ICD No

Pacing No



No


Po

lan

d





2014 2015







Number of ablation centres (> 10 VT ablations on structural heart diseases) not available 19







12. Guidelines


National Yes

U.S. No

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Heart Rhythm Section of Polish Cardiac Society



Official statistics

Estimation

Po

rtu

gal


PORTUGAL


1. Statistics

Age pyramid for Portugal

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Po

rtu

gal








Population 10.825.309 2015










64,0 2012


36,0 2012

* IMF estimative

2. Country


2014 2015




In 2006, 81,1% of the resident population resorted mostly the National Health Service (NHS) to have access to health services, The second most mentioned subsystem corresponded to the Civil Servants Health Subsystem (ADSE), used by 10,1% of residents in 2006. In the same year private insurances supported 2,4% of the health expenditure and the private health subsystem supported 1,9% of the health expenditure.(source Portuguese National Health Plan 2012–2016, Portuguese Directorate-General of Health, and Organization for Economic Co-operation and Development)


All residents in Portugal have access to health care provided by the National Health Service (NHS), financed mainly through taxation. CO-payments have been increasing over time, and the level of cost sharing is highest for pharmaceutical products. • Approximately one-fifth to a quarter of population enjoys a second (or more) layer of health insurance coverage through health subsystems and voluntary health insurance.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No

Comments: co-payment necessary only in the private sector

Po

rtu

gal



No restrictions




Not funded

No answer

Comments: Hospital budgets are drawn up and allocated by the Ministry of Health. At present, public hospitals are allocated global budgets based on contracts (cotraros programa) signed with the Ministry of Health. As the year budget is reached, there may be restrictions on certain number of treatments.



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Physician reimbursement only if working in the private sector




Yes, it´s required

for practice


for practice


Device therapy Portuguese Medical Association

Invasive electrophysiology Portuguese Medical Association (Ordem dos Médicos),

College of Subspecialty in Electrophysiology


Training centres Portuguese Medical Association (Ordem dos Médicos)





No

No answer


Specialist


ICD or pacemaker implants Yes Cardiologist, cardiac sugreon


Yes

Portuguese Medical Association (Ordem dos Médicos), College of Subspecialty in Electrophysiology





Responsible person for quality control no answer

Po

rtu

gal


5. Pacemakers



Surgeons Yes 1 %


2014 2015

















2014 2015







Surgeons No 0 %




2014 2015


Total ICD units implanted not available 1.224




First implants 819 1.001


8. Loop recorders


2014 2015





Surgeons No 0 %


Cardiologists Yes 100%

Surgeons No 0 %

9. Lead extractions


2014 2015






Po

rtu

gal


10. Device specific



Official name

ICD Yes

Pacing Yes

Electrophysiology Yes


Yes





2014 2015











Number of electrophysiologists performed catheter ablation independently not available 25




12. Guidelines


National Yes

U.S. No

European No


1 2 3 4 5

Lack of centres 6


1

Lack of referral 2



Lack of operators 4


13. Sources


Portuguese Association of Arrhythmias, Pacing and Electrophysiology



Official statistics


Estimation

Ro

man

ia


ROMANIA


1. Statistics

Age pyramid for Romania

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1992*

40–64 years

2030

2015

1992*

20–39 years

2030

2015

1992*

< 20 years

2030

2015

1992*


Ro

man

ia








Population 21.666.350 2015










80,3 2012


19,7 2012

* IMF estimative

2. Country


2014 2015

60 % not available



National Health System, some private clinics and hospitals, some of them receiving partial funds from NHS (The Ministry of Health is the coordinator of Health System)


Requirements for citizens to qualify for public insurance: to be employed, socialy assisted or retired


2014 2015




2014 2015






ICD devices Yes

Pacemakers Yes

Ablation Yes

Comments: Yes, only in private sector



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: National Programs are available in selected centers, but limited by budget

Ro

man

ia



No restrictions




Not funded

No answer

Comments: National Programs are available in selected centers, but limited by fixed budget




practice


for practice


Device therapy



Training centres





No

No answer

Comments: We advanced the formalities for National Certification, and EHRA certification will be homologated as National Certification


Specialist




No



5. Pacemakers



Surgeons Yes 1 %


2014 2015




First implants not available 3.538



1 year



We do not have a quality control system


Pacemaker 9

ICD implantation 9

CRT implantation 9







Ro

man

ia




2014 2015







Surgeons No 0 %



2014 2015










Surgeons No 0 %


10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons No 0 %


Official name

ICD No

Pacing No



No


Ro

man

ia





2014 2015













12. Guidelines


National No answer

U.S. No answer

European Yes


1 2 3 4 5

Lack of centres 6


1

Lack of referral 2



Lack of operators 5



13. Sources


Romanian Society of Cardiology, Working Group on Arrhythmias, Electrophysiology and Implantable Devices




Estimation

Ru

ssia

n F

eder

atio

n


RUSSIAN FEDERATION


1. Statistics

Age pyramid for Russian Federation

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Ru

ssia

n F

eder

atio

n








Population 142.423.773 2015










51,1 2012


48,9 2012

* IMF estimative

2. Country


2014 2015

53 % 53 %



Mandatory health insurance


Requirements for citizens to qualify for public insurance: All citizens


2014 2015




2014 2015






ICD devices No

Pacemakers Yes

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Ru

ssia

n F

eder

atio

n



No restrictions




Not funded

No answer

Comments: NICE, Ministry of Health




practice


for practice


Device therapy NSCA

Invasive electrophysiology NSCA


Training centres NSCA





No

No answer


Specialist

Catheter ablation Yes Cardiologist, surgeon



Yes

National (Russian) Society of Cardiac Arrhuthmias (NSCA)


3 years


3 years


5. Pacemakers



Surgeons Yes 18 %

Other: 2 %


2014 2015





Replacements 5.633 0


NSCA


Pacemaker 10

ICD implantation 7

CRT implantation 7



Number of universities (Schools of Medicine) not available




Pacemaker Yes




Ru

ssia

n F

eder

atio

n




2014 2015







Surgeons Yes 60 %



2014 2015




Thereof, Dual chamber 1.124 990






Surgeons Yes 30 %


10. Device specific


Reasons why remote monitoring is not available: Biotronik Home Monitoring, Medtronic CareLink

9. Lead extractions

Lead extractions procedures and number of centers that performed lead extractions

2014 2015







Official name

ICD Yes NSCA

Pacing Yes NSCA

Electrophysiology Yes NSCA


Yes

Federal center for interventional and surgical Arrhythmology


8. Loop recorders


2014 2015






Ru

ssia

n F

eder

atio

n



Official name: NSCA



2014 2015






Number of VT/VF ablations 2.408 1.771







95 66

12. Guidelines


National Yes

U.S. No answer

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


National (Russian) Society of Cardiac Arrhythmias (NSCA)



Official statistics - Ministry of Health

Survey from professional association - NSCA

San

Mar

ino


SAN MARINO


1. Statistics

Age pyramid for San Marino

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1995*

40–64 years

2030

2015

1995*

20–39 years

2030

2015

1995*

< 20 years

2030

2015

1995*


San

Mar

ino


















87,2 2012


12,2 2012

* IMF estimative

2. Country


2014 2015




National health system provides for total health expenses coverage, for each citizen, from birth to death.


Requirements for citizens to qualify for public insurance: Citizenship and residency in San Marino.


2014 2015

Insured citizens not available 100 %

Uninsured citizens not available 0 %


2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

San

Mar

ino



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiologist with experience and proficiency in catheter ablation

ICD or pacemaker implants Yes Cardiologist with experience and proficiency in PM/ICD implants


No




5. Pacemakers



Surgeons No 0 %


2014 2015


Total Pacemaker units implanted not available 11





National Health Institute


Pacemaker 1

ICD implantation 1

CRT implantation 1




Pacemaker Yes







San

Mar

ino




2014 2015


Total CRT units implanted not available 2





Surgeons No 0 %



2014 2015


Total ICD units implanted not available 8








Surgeons No 0 %

8. Loop recorders


2014 2015





Surgeons No 0 %


10. Device specific


Reasons why remote monitoring is not available: Implementing is underway

9. Lead extractions


2014 2015

Hospitals performed lead extractions not available 0

Total lead extraction procedures not available 0



Surgeons No 0 %

Comments: collabration with foreign hospitals for lead extraction (where trained cardiologists perform the intervention)


Official name

ICD Yes State Hospital Registry, belonging to National Health Institute

Pacing Yes State Hospital Registry, belonging to National Health Institute



No


Official name: State Hospital Registry, belonging to National Health Institute

San

Mar

ino





2014 2015

Number of ablation centres not available 0

Number of ablations performed not available 0

Mean number of ablations per centre not available 0

Number of AF ablations not available 0

Number of ablation centres (> 50 AF ablations) not available 0


Number of ablation centres (> 10 VT ablations on structural heart diseases) not available 0





Number of physicians under training to become independent electrophysiologists not available 0

12. Guidelines


National No answer

U.S. No

European Yes


1 2 3 4 5

Lack of centres 4


3

Lack of referral 5



Lack of operators 1



13. Sources


Società Sammarinese di Cardiologia



Official statistics - National Health Institute


Serb

ia


SERBIA


1. Statistics

Age pyramid for Serbia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Serb

ia


















61,2 2012


38,8 2012

* IMF estimative

2. Country


2014 2015

56 % 56 %



National Health System with full insurance for all citizens



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No

Comments: Private health insurance is possible, but for now, there is no hospitals that are used for implantation, and electrophysiological procedure.



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: By the decision of the Ministry of Health for all the materials that are permanently implanted in the human body is charged in the amount of 5 % of its value, but with defined limited maximum price which the patient can pay.

Serb

ia



No restrictions




Not funded

No answer




practice


for practice


Device therapy National Reference Centre in consultation with the Ministry of Health


Allied professionals Serbian Medical Chamber

Training centres National Reference Centre in consultation with the Ministry of Health





No

No answer


Specialist


ICD or pacemaker implants Yes Cardiologist or cardiovascular surgeon


No answer


5. Pacemakers



Surgeons Yes 2 %


2014 2015







Ministry of Health


Pacemaker 4

ICD implantation 4

CRT implantation 4









1 year


1 year

Serb

ia




2014 2015







Surgeons No 0 %



2014 2015







Replacements 63 41



Surgeons No 0 %

8. Loop recorders


2014 2015





Surgeons No 0 %



10. Device specific


9. Lead extractions


2014 2015





Surgeons No 0 %


Official name

ICD Yes Implementation of the pilot phase

Pacing Yes Implementation of the pilot phase



Yes

Expert Group within the framework of the Health Insurance Fund

Serb

ia





2014 2015













12. Guidelines


National Yes

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres 5


1

Lack of referral 6



Lack of operators 4



13. Sources


Cardiology Society of Serbia, Working Group on Cardiac Pacing



Survey from professional association - National Referreal Pacemaker Center

Official statistics - Insitute of Public Health of Serbia, Ministry of Health

Slo

vaki

a


SLOVAKIA


1. Statistics

Age pyramid for Slovakia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Slo

vaki

a


















69,7 2012


30,3 2012

* IMF estimative

2. Country


2014 2015

47 % 45 %






2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Slo

vaki

a



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiologist (training in ablations)

ICD or pacemaker implants Yes Cardiologist (training in implantations), cardio surgeon (training in implantations), vascular surgeon (training in implantations)


Yes


5. Pacemakers



Surgeons Yes 2 %


2014 2015








State Institution for Drug Conctrol


Pacemaker 3

ICD implantation 3

CRT implantation 3









Slo

vaki

a




2014 2015







Surgeons No 0 %



2014 2015










Surgeons Yes 2 %


10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons Yes 5 %


Official name

ICD Yes

Pacing Yes SLOVIMPULZ - Registry of Slovak Heart Rhythm Ass. (SASA)

Electrophysiology Yes SLOVABLO - Registry of Slovak Heart Rhythm Ass. (SASA)

Slo

vaki

a



Official name: SLOVABLO - registry of Slovak Heart Rhythm Ass.


Yes

Official name: State Institute for Drug Control (SUKL)




2014 2015
















1 2 3 4 5

Lack of centres 6


1

Lack of referral 2



Lack of operators 4


13. Sources


Slovak Heart Rhythm Ass. (SASA)




Sales data

Estimation

Other

12. Guidelines


National Yes

U.S. No

European Yes

Slo

ven

ia


SLOVENIA


1. Statistics

Age pyramid for Slovenia

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Slo

ven

ia


















71,5 2012


28,5 2012

* IMF estimative

2. Country


2014 2015




NHS Fund



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Slo

ven

ia



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist

Catheter ablation Yes Internist, cardiologist

ICD or pacemaker implants Yes Internist, cardiologist, surgeon


No


5. Pacemakers



Surgeons Yes 80 %


2014 2015









Agency of the Republic of Slovenia for Medicines and Medical Devices


Pacemaker 2

ICD implantation 2

CRT implantation 2




Pacemaker Yes



Cathether ablation No



Percentage of academic centres among all practicing implanting devices centres 22%

Slo

ven

ia




2014 2015







Surgeons No 0 %



2014 2015







Replacements 18 24





10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015

Hospitals performed lead extractions not available 1




Surgeons Yes 50 %



Surgeons Yes 100 %


Official name

ICD Yes Working Group on Arrhythmias, Slovenian Society of Cardiology

Pacing Yes Working Group on Arrhythmias, Slovenian Society of Cardiology

Electrophysiology Yes Working Group on Arrhythmias, Slovenian Society of Cardiology


Yes

Official name: Agency of the Republic of Slovenia for Medicines and Medical Device


Official name: Agency of the Republic of Slovenia for Medicines and Medical Device

Slo

ven

ia



Official name: Working Group on Arrhythmias, Slovenian Society of Cardiology



2014 2015













12. Guidelines


National No

U.S. No

European Yes


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Working Group on Arrhythmias, Slovenian Society of Cardiology




Estimation

Spai

n


SPAIN


1. Statistics

Age pyramid for Spain

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Spai

n








Population 48.146.134 2015










71,7 2012


28,3 2012

* IMF estimative

2. Country


2014 2015

33 % 30,09 %



Spanish healthcare is based on a national health system that covers almost all population. Regional autonomous communities have their own budget and decide how to organize and deliver resources. Private insurance companies offer complementary healthcare coverage.


Employed or self-employed persons affiliated (contributors) to the Social Security • Pensioners of the Social Security System • Unemployed persons receiving unemployment benefits • Unemployed persons who have exhausted unemployment benefits • Persons not previously covered, with incomes less than 100.000€ an-nually, which are in some of the following situations: • Spanish nationality residing in Spanish territory • Nationals of a Member State of the European Union, the European Economic Area or Switzerland registered in the Central Register of Foreigners. • Nationals of a country other than those mentioned in the preceding paragraphs, or stateless persons, and holders of an authorization to reside in Spanish territory, while it remains in force under the terms provided in their specific legislation. • A person has the status of beneficiary of an insured person when is one of the following situations: Being the spouse of the insured person or living with him/her with a relationship similar to marriage affectivity, forming a partnership. • Be former spouse, or be judicially separated. • Descendant, or person assimilated to it, the insured person or spouse, even if it is legally separated from his former dependent spouse or partner, in both cases by the insured and under 26 year-old or, should be over that age have a disability recognized in an equal or greater than 65% grade.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No

Comments: Yes, only in the private sector

Spai

n



No restrictions




Not funded

No answer



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: In the private sector, the physician/hospital receives per process reimbursement.




practice


for practice


Device therapy Cardiac stimulation accre-ditation (Acreditación en estimulación cardiaca)

Invasive electrophysiology Acreditación de formación especifica y excelencia para la práctica en Electrofisiologia Cardiaca Intervencionista


Training centres Acreditación de Centros para la formación en Electrofisiologia



Specialist





Yes

Spanish Society of Cardiology


2 years



Each Centre and Department















No

No answer

Spai

n


5. Pacemakers



Surgeons Yes 24 %

Other Intensive Care specialists 5 %


2014 2015








2014 2015







Surgeons Yes 2 %



2014 2015



Thereof, Single chamber 2.903 not available

Thereof, Dual chamber 966 not available





8. Loop recorders


2014 2015



9. Lead extractions


2014 2015


Total lead extraction procedures not available 400



Surgeons No 0 %



Surgeons Yes 70 %



Surgeons Yes 8 %

Spai

n



2014 2015






Number of VT/VF ablations 711 1.124







not available 50

10. Device specific



Official name

ICD Yes Spanish Implantable Cardioverter-defibrillator Registry. Arrhythmia Working Group. Spanish Society of Cardiology

Pacing Yes Spanish Pacemaker Registry. Working Group on Cardiac Pacing. Spanish Society of Cardiology

Electrophysiology Yes Spanish Catheter Ablation Registry. Arrhythmia Working Group. Spanish Society of Cardiology


Official name: Spanish Catheter Ablation Registry. Arrhythmia Working Group. Spanish Society of Cardiology


Yes

Official name: Ministry of Health in collaboration with Arrhythmia Working Group and Working Group on Cardiac Pacing, Spanish Society of Cardiology





1 2 3 4 5

Lack of centres 4


1

Lack of referral 2



Lack of operators 5


13. Sources


Sección de Electrofisiologia y Arritmias de la Sociedad Española de Cardiologia (Arrhythmia Working Group of the Spanish Society of Cardiology) • Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (Working Group of Cardiac Pacing of the Spanish Society of Cardiology)



Official statistics - Ministry of Health and Ministry of Education

Survey from professional association - Spanish Society of Cardiology Working Groups

Sales data

Estimation

Other - IDIS Foundation

12. Guidelines


National Yes

U.S. No

European Yes

Swed

en


SWEDEN


1. Statistics

Age pyramid for Sweden

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Swed

en


















81,3 2012


18,7 2012

* IMF estimative

2. Country


2014 2015

not available 37 %



Basic insurance availability No answer


2014 2015




2014 2015






ICD devices No answer

Pacemakers No answer

Ablation No answer



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Swed

en



No restrictions




Not funded

No answer




practice


for practice


Device therapy



Training centres





No

No answer


Specialist


ICD or pacemaker implants No answer


No answer




5. Pacemakers



Surgeons Yes 18 %

Other: Anaesthesiologists 18 %


2014 2015


Total Pacemaker units implanted 9.421 not available





No answer










Willingness to install quality control system 0


Swed

en




2014 2015








Other: Anaesthesiologists not available



2014 2015


Total ICD units implanted 2.097 not available




First implants 1.506 870




Surgeons Yes 14 %

Anaesthesiologists 5 %


8. Loop recorders


2014 2015






Anaesthesiologists not available

10. Device specific


9. Lead extractions


2014 2015






Other: no answer not available


Official name

ICD No answer

Pacing No answer

Electrophysiology No answer


No answer


Swed

en


Availability of a national registry for interventional electrophysiology No answer

0



2014 2015


Number of ablations performed 4.803 not available

Mean number of ablations per centre 480 not available

Number of AF ablations 1.791 not available









13 not available

12. Guidelines


National No answer

U.S. No answer

European No answer


1 2 3 4 5

Lack of centres


Lack of referral



Lack of operators



13. Sources


Heart Rhythm Group (HRG)



Official statistics

Sales data

Other

Swit

zerl

and


SWITZERLAND



1. Statistics

Age pyramid for Switzerland

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Swit

zerl

and


















65,8 2012


34,2 2012

* IMF estimative

2. Country


2014 2015

35 % not available



National healthcare and private healthcare. Obligatory health insurance to be contracted by all inhabitants.


Requirements for citizens to qualify for public insurance: Inhabitant of the country (declared or not). The insurance is however not free.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Comments: Needs to be a cardiologist or cardiovascular surgeon to have reimbursement

Swit

zerl

and



No restrictions




Not funded

No answer






No

No answer


Specialist




Yes

Swiss Working Group on Pacing and Electrophysiology


1 year



practice


for practice


Device therapy EHRA certification



Training centres According to 2015 Swiss guidelines


5. Pacemakers



Surgeons Yes 5 %


2014 2015








Swiss Working Group on Pacing and Electrophysiology


Pacemaker 6

ICD implantation 6

CRT implantation 6




Pacemaker Yes







Swit

zerl

and




2014 2015







Surgeons No 0 %



2014 2015










Surgeons Yes 5 %

8. Loop recorders


2014 2015





Surgeons No 0 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 20 %


Official name

ICD Yes CHPACEWEB

Pacing Yes CHPACEWEB

Electrophysiology Yes CHPACEWEB


Yes

Official name: CHPACEWEB



Swit

zerl

and






2014 2015













15 not available


1 2 3 4 5

Lack of centres 5


3

Lack of referral 1



Lack of operators 6


12. Guidelines


National No answer

U.S. No answer

European Yes


13. Sources


Working Group of Pacing and Electrophysiology of the Swiss Society of Cardiology




Estimation

Tu

rkey


TURKEY


1. Statistics

Age pyramid for Turkey

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Tu

rkey








Population 79.414.269 2015










76,8 2012


23,2 2012

* IMF estimative

2. Country


2014 2015




National Health Care System (Social Security Institution -SSI) covers almost all population. Private insurance companies offer complementary health care.


Requirements for citizens to qualify for public insurance: Working population that has acquired policy and their family, retired population.


2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No

Comments: Yes, only in the private sector



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Tu

rkey



No restrictions




Not funded

No answer

Body issuing the guidelines: Health Application InstructionsComments: Social Security Institution publish a guideline called ‚‘Health Application Instructions‘‘ which reports the indications and the amount of reimbursement for each procedure. Indications follow ESC guidelines.




practice


for practice


Device therapy



Training centres





No

No answer


Specialist


ICD or pacemaker implants Yes Cardiologist, cardiovascular surgeon


No


5. Pacemakers



Surgeons Yes 5 %


2014 2015







None














Tu

rkey




2014 2015







Surgeons Yes 1 %



2014 2015







Replacements 900 1.066

8. Loop recorders


2014 2015





Surgeons No 0 %



Surgeons Yes 3 %


10. Device specific


Reasons why remote monitoring is not available: Reimbursement problems

9. Lead extractions


2014 2015





Surgeons Yes 25 %


Official name

ICD No

Pacing No



No


Tu

rkey





2014 2015

Number of ablation centres not available not available













12. Guidelines


National Yes

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres 2


1

Lack of referral 6



Lack of operators 5



13. Sources


Turkish Society of Cardiology, Working Group on Arrhythmias



Official statistics

Estimation

Ukr

ain

e


UKRAINE


1. Statistics

Age pyramid for Ukraine

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1990*

40–64 years

2030

2015

1990*

20–39 years

2030

2015

1990*

< 20 years

2030

2015

1990*


Ukr

ain

e








Population 44.429.471 2015










55,4 2012


44,6 2012

* IMF estimative

2. Country


2014 2015

67,3 % not available



Ministry of Public Health of Ukraine, National Academy of Medical Sciences of Ukraine (National Scientific Centres – 36 in total), profile institutional hospitals (hospital of the Ministry of Internal Affairs, hospital of the Ministry of Defence so on), State sanitary and epidemiological service, State Administration of Ukraine on medical products, State service of Ukraine on HIV/AIDS and other socially dangerous diseases. National health system provides all citizens of Ukraine with the free medical and preventive help in accordance to acting legislation by: emergency, outpatient (ambulatory-policlinic) help, stationary (general profile and specialized) help.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Ukr

ain

e



No restrictions




Not funded

No answer




practice


for practice


Device therapy Invasive and non invasive arrhythmology

Invasive electrophysiology Invasive and non invasive arrhythmology


Training centres





No

No answer


Specialist

Catheter ablation Yes Cardiovascular surgeon or cardiologist

ICD or pacemaker implants Yes Cardiovascular surgeon or cardiologist


Yes

Рекомендації Ассоціації Кардіологів України /Recommendations of Association of Cardiologists of Ukraine/ Рекомендації Ассоціації Аритмологів України/Recommendations of Association of Arrhythmologists of Ukraine


5. Pacemakers


Cardiologists Yes 10,3 %

Surgeons Yes 89,7 %


2014 2015




First implants 4,299 4.110



Ministry of Health of Ukraine, National Academy of Medical Sciences of Ukraine


Pacemaker 4

ICD implantation 2

CRT implantation 2




Pacemaker Yes



Catheter ablation Yes


Percentage of academic centres among all practicing EP centres 27,3%

Percentage of academic centres among all practicing implanting devices centres 8,6 %



Ukr

ain

e




2014 2015







Surgeons Yes 80 %



2014 2015







Replacements 10 13


Cardiologists Yes 14,3%

Surgeons Yes 85,7 %

8. Loop recorders


2014 2015





Surgeons Yes 50 %


10. Device specific


9. Lead extractions


2014 2015





Surgeons Yes 100 %


Official name

ICD No

Pacing No



No


Ukr

ain

e





2014 2015



Mean number of ablations per centre 296 208,5











12. Guidelines


National Yes

U.S. Yes

European Yes


1 2 3 4 5

Lack of centres 6


1

Lack of referral 2



Lack of operators 4



13. Sources


Association of Arrhythmologists of Ukraine



Association of Arrhythmologists of Ukraine

State Statistic Service of Ukraine, Ministry of Public Health of Ukraine

Un

ited

Kin

gd

om


UNITED KINGDOM


1. Statistics

Age pyramid for United Kingdom

Male Female

30 25 20 15 10 5 0 0 5 10 15 20 25 30

Perc

ent > 65 years

2030

2015

1991*

40–64 years

2030

2015

1991*

20–39 years

2030

2015

1991*

< 20 years

2030

2015

1991*


Un

ited

Kin

gd

om








Population 64.088.222 2015










84,0 2012


16,0 2012

* IMF estimative

2. Country


2014 2015

22 % 22 %



NHS for all citizens. Private healthcare optional.



2014 2015




2014 2015






ICD devices No

Pacemakers No

Ablation No



reimbursement



following year)


No answer





CRT devices

Ablation

Leadless Pacing

Subcutaneous ICD

Un

ited

Kin

gd

om



No restrictions




Not funded

No answer




practice


for practice


Device therapy BHRS certification in CIEDs


BHRS certification in cardiac electrophysiology

Allied professionals BHRS certification in CIEDs and electrophysiology SCST certification

Training centres





No

No answer


Specialist

Catheter ablation Yes A cardiac electrophysiologist is required for catheter ablation.

ICD or pacemaker implants Yes A trained cardiologist or cardiac surgeon may undertake device implants.


Yes

BHRS standards documents in CIEDs and electrophysiology



BHRS through national audit.








Pacemaker Yes








Cardiology trainees have a 5 year training programme. If they wish to specialise in device implantation, the final 2 years are focussed in this area.


Un

ited

Kin

gd

om


5. Pacemakers



Surgeons No 0 %


2014 2015








2014 2015







Surgeons No 0 %



2014 2015










Surgeons No 0 %



Official name: National Cardiac Rhythm Management Audit (NICOR)

10. Device specific


8. Loop recorders


2014 2015



9. Lead extractions


2014 2015





Surgeons No 0 %



Surgeons No 0 %


Official name

ICD Yes National Cardiac Rhythm Management Audit (NICOR)

Pacing Yes National Cardiac Rhythm Management Audit (NICOR)

Electrophysiology Yes National Cardiac Rhythm Management Audit (NICOR)


Yes

Official name: Medicines and Healthcare Regulatory Authority (MHRA)

Un

ited

Kin

gd

om



Official name: National cardiac rhythm management audit NICOR)

12. Guidelines


National Yes

U.S. No

European No


1 2 3 4 5

Lack of centres 6


2

Lack of referral 4



Lack of operators 5




2014 2015















13. Sources


British Heart Rhythm Society



Official statistics

Estimation

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5. Appendix


5. Appendix

EHRA Certification

The EHRA offers the first European certification of professional excellence, in three areas:

• Electrophysiology • Cardiac Pacing & Device Therapy • Allied Professionals

The EHRA is pleased to publish the list, starting from 2005, of professionals who are officially fully certified, as well as that of the candidates who have passed the written part of the certification process. «Join us in congratulating them!»

Candidates successful to the exam need to have their logbook assessed by an EHRA grader to be fully certified. EHRA Certification is valid for 10 years.

ElectrophysiologyEHRA EP Certified professionals

ACENA RAMOS Marta Spain 2014ACOU Willem-Jan Belgium 2015ADIYAMAN Ahmet Netherlands 2014ALCALDE RODRIGUEZ Oscar Spain 2012ALI Hussam Italy 2015ALZAND B. Netherlands 2012ANDERSON Mark H. United Kingdom 2010ANGUERA CAMOS Ignacio Spain 2009ANNE Wim Belgium 2013ARBELO Elena Spain 2009ARCOCHA TORRES Maria Fe Spain 2012ARIAS PALOMARES Miguel Angel Spain 2013ARMENTA PASTOR Juan Fernandez Spain 2012AVELLA Andrea Italy 2009ÁVILA ALONSO Pablo Spain 2013AYALA PAREDES Felix Canada 2009BALTA Osman Germany 2013BARDYSZEWSKI Aleksander Poland 2015BARRERA CORDERO Alberto Spain 2005BAYRAK Duhan Fatih Belgium 2012BEAUPORT Joelle Germany 2013BELOTTI Giuseppina Italy 2008BENCSIK Gabor Hungary 2009BERRUEZO SANCHEZ Antonio Spain 2010BERTOMEU-GONZALEZ Vicente Spain 2012BISBAL Felipe Belgium 2015BLAAUW Yuri Netherlands 2015BONANNO Carlo Italy 2014BROUZET Thomas Spain 2015BRUGADA Josep Spain 2009BUERKLE Gerd Austria 2011BUN Sok-Sithikun France 2012

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EHRA EP Certified professionals

BURRI Haran Switzerland 2008CALVO CUERVO David Spain 2013CALVO GALIANO Naiara Spain 2012CANO PEREZ Oscar Spain 2011CASTRO URDA Victor Spain 2012CATANCHIN Andrei Australia 2012CHATTERJEE Debjit United Kingdom 2013CHONG Daniel Singapore 2013CIPOLLETTA Laura Italy 2015CLEMENS Marcell Hungary 2015CORTEZ-DIAS Nuno Portugal 2015COZAR LEON Rocio Spain 2012DATINO Tomas Spain 2012DAVOODI Gholamreza Ireland 2008DE DIEGO Carlos Spain 2015DE FILIPPO Paolo Italy 2012DE GROOT Joris R. Netherlands 2012DE JONG Jonas Netherlands 2013DE MEYER Grim Belgium 2014DE RIVA SILVA Marta Spain 2013DELGADO Hugo Emilio Argentina 2014DEUTSCH Alexandru Romania 2012DI CORI Andrea Italy 2015DJAJADISASTRA Achmad Iskandar Germany 2012DOMINGUEZ MAFE Eloy Spain 2014DURAY Gabor Zoltan Germany 2008DYRDA Katia Canada 2012EISENBERGER Martin Czech Republic 2012EL KADRI Moutaz United Kingdom 2013ELDER Douglas United Kingdom 2013EVERTZ Reinder Netherlands 2015EWERTSEN Niels Christian Germany 2014FERNANDEZ LOZANO Ignacio Spain 2005FERNANDEZ PASTOR Julia Spain 2015FONTENLA Adolfo Spain 2012FORCLAZ Andrei Switzerland 2012FOSCH Javier Spain 2015FRANCK Harald Germany 2011FRANZINI Christine Switzerland 2015GALLARDO LOBO Rodrigo Spain 2012GARCIA MORAN Emilio Spain 2005GAROFALO FORTE Daniel Spain 2014GAWRYSIAK Marcin Poland 2013GLOWNIAK Andrzej Poland 2012GONZALEZ FERRER Juan Jose Spain 2015GONZALEZ VASSEROT Maria Del Mar Spain 2009GONZALEZ-ENRIQUEZ Susana Spain 2012GOPALAMURUGAN A. B. United Kingdom 2014GRECU Mihaela Romania 2007GRUBB Neil United Kingdom 2014



GUGUCHEV Pavel United States of America 2010HEMELS Martin Netherlands 2012HERCZKU Csaba Hungary 2012HERREROS GUILARTE Benito Spain 2005HLIVAK Peter Slovakia 2012HUYBRECHTS Wim Belgium 2009INFUSINO Tommaso Italy 2013JANDA Igor Germany 2012JANSEN Ward Netherlands 2010JASTRZEBSKI Marek Poland 2008JILEK Clemens Germany 2012JIMENEZ JAIMEZ Juan Spain 2015JIMENEZ-DIAZ Javier Spain 2015JOHAR Sofian United Kingdom 2012JONES David Gareth United Kingdom 2012JOST Colin Germany 2015KACZMAREK Krzysztof Poland 2013KARDOS Attila Hungary 2012KEMME Michiel The netherlands 2009KILISZEK Marek Poland 2010KONSTANTINIDOU Melanie Germany 2013KOOPMAN Pieter Belgium 2014KOSTOPOULOU Anna Greece 2014KRISTENSEN Jens Denmark 2014KUHNE Michael Switzerland 2012LANG Christopher United Kingdom 2014LAURENZI Francesco Italy 2009LE POLAIN DE WAROUX Jean-Benoit Belgium 2015LERCHER Peter Austria 2012LETSAS Konstantinos Greece 2009LOUW Ruan South Africa 2014LUBINSKI Andrzej Poland 2005LUEDORFF Guido Germany 2012LUERMANS Justin Netherlands 2014LUQUE Antonio Spain 2015MADRID Antonio Spain 2008MARINI Massimiliano Italy 2011MARTINEK Martin Austria 2010MARTINEZ ALDAY Jesus Daniel Spain 2005MARTINEZ SANDE Jose Luis Spain 2012MATIA FRANCES Roberto Spain 2011MATIELLO Maria Spain 2011MAZUR Alexander Israel 2005MORENO REVIRIEGO Sara Spain 2014MOYA I MITJANS Angel Spain 2005MUELLER Stephan Andreas Switzerland 2012MUNDEL Markus Germany 2013NAGEH-ARMANIOS Maged United States of America 2012NAVARRETE CASAS Antonio Javier United States of America 2008NENTWICH Karin Germany 2013

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NOVAK Jan United Kingdom 2013ORMAETXE MERODIO Jose Miguel Spain 2005OSCA ASENSI Joaquin Spain 2010ÖZCAN Emin Evren Turkey 2014PACHON Marta Spain 2014PADFIELD Gareth United Kingdom 2015PAPIASHVILI Giorgi Georgia 2009PASTOR FUENTES Agustin Spain 2005PAURIAH Maheshwar United Kingdom 2015PAVLOVIC Nikola Croatia 2014PEINADO Rafael Spain 2005PELAEZ GONZALEZ Antonio Spain 2015PEREZ ALVAREZ Luisa Spain 2014PEREZ CASTELLANO Nicasio Spain 2005PEREZ DIEZ Diego Spain 2012PEREZ-VILLACASTIN Julian Spain 2005PISON Laurent Netherlands 2013POELSLER Robert Germany 2014POZZETTI Daniela Italy 2007PRISECARU Raluca Belgium 2015PUCHOL Alberto Hungary 2012RACKAUSKAS Gediminas Lithuania 2015REBELLATO Luca Italy 2012RICCIARDI Danilo Belgium 2013RIVAS GANDARA Nuria Spain 2013RIVERA Santiago Canada 2013ROCA LUQUE Ivo Spain 2014RODRIGUEZ MANERO Moises Belgium 2013RORDORF Roberto Italy 2012ROSSI Luca Italy 2014ROSSI Andrea Italy 2014ROTEN Laurent Switzerland 2009ROUX Antoine France 2013SABATE DE LA CRUZ Xavier Spain 2005SALGADO ARANDA Ricardo Spain 2014SALGUERO BODES Rafael Spain 2009SAMO AYOU Romeo Sweden 2011SANZO Antonio Italy 2015SAUSE Armin Germany 2009SCHIMPF Rainer Germany 2012SCHOONDERWOERD Bas Netherlands 2012SEBAG Frederic France 2014SEGRETI Luca Italy 2013SEGURA VILLALOBOS Federico Spain 2012SEILER Jens Switzerland 2013SEOW Swee-Chong Singapore 2007SERVATIUS Helge Switzerland 2014SGARITO Giuseppe Italy 2014SIEIRA RODRIGUEZ-MORET Juan Antonio Spain 2015SILISTE Calin Italy 2013



SKENE Christopher United Kingdom 2014SMIT Jaap Jan The netherlands 2009STANLEY Anthony South Africa 2014STEFFEL Jan Switzerland 2012STOECKEL Holger Switzerland 2015STUEHLINGER Markus Austria 2010SZABO Albin Arpad Hungary 2012SZEPLAKI Gabor Hungary 2012TEIJEIRA FERNANDEZ Elvis United Kingdom 2012TER BEKKE Rachel M.A. Netherlands 2015TOMAN Ondrej Czech Republic 2013TOQUERO RAMOS Jorge Spain 2005TORCIVIA Riccardo Italy 2015TRINES Serge Alexander Ivo Petrus Netherlands 2008TRUCCO DE RINAUDO María Emilce Spain 2015TUTDIBI Osman Germany 2013TUTUIANU Cristina Ioana Romania 2015TZEIS Stylianos Greece 2010UCER Ekrem Germany 2012VACCARI Diego Italy 2013VALVERDE ANDRE Irene Spain 2013VAN CASTEREN Lieve Belgium 2012VAN DER HEIJDEN Jeroen Netherlands 2015VAN HEUVERSWYN Frederic Belgium 2015VAN OPSTAL Jurren Netherlands 2014VATASESCU Radu-Gabriel Romania 2009VENABLES Paul United Kingdom 2013VILLUENDAS SABATE Roger Spain 2013VITALE Raffaele Italy 2012VOCKE Wolfgang Germany 2013VOSS Frederik Germany 2009VUKAJLOVIC Dejan Germany 2010WETZEL Renate Ulrike Germany 2015WIJCHERS Sip Belgium 2015WINTER Siegmund Austria 2012YEO Wee Tiong Singapore 2013ZELJKO Hrvojka Marija Croatia 2013ZELLERHOFF Stephan Germany 2015ZOPPO Franco Italy 2008ZUCCHELLI Giulio Italy 2012

EP Certification candidates who have successfully completed the exam

ABALEA Jerome France 2014ABEDIN Zainul United States Of America 2007ÁBRAHAM Pál Hungary 2013ACENA RAMOS Marta Spain 2011ACOSTA MARTINEZ Juan Spain 2014ACOU Willem-Jan Belgium 2013

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ADIYAMAN Ahmet Netherlands 2014AHMED TAHER MAHMOUD Ahmed Egypt 2013AHUMADA Miguel Spain 2013AKERSTROM Finn Sweden 2015AL AMOURA Alaa France 2015AL BUNNI Muhamad Italy 2007ALCALDE RODRIGUEZ Oscar Spain 2010ALGARRA CULLELL Maria Spain 2013ALI Hussam Italy 2014ALIYEV Farid Turkey 2010ALZAND B. Netherlands 2012AMET Denis France 2011ANDERSON Mark H United Kingdom 2010ANGUERA CAMOS Ignacio Spain 2008ANIC Ante Croatia 2013ANNE Wim Belgium 2010ANTOLIC Bor Slovenia 2015ARBELO Elena Spain 2007ARCOCHA TORRES Maria Fe Spain 2009ARGUEDAS-JIMENEZ Hugo Spain 2014ARIAS PALOMARES Miguel Angel Spain 2010ARISHA Mohamed Mousa France 2015ARMENTA PASTOR Juan Fernandez Spain 2011ARND Christoph Germany 2014ATTA Salah Eldin Sayed Saudi Arabia 2010AVELLA Andrea Italy 2007ÁVILA ALONSO Pablo Spain 2013AYALA PAREDES Felix Canada 2007AZEM Tareq Germany 2014BALT Jippe Netherlands 2013BALTA Osman Germany 2010BARDYSZEWSKI Aleksander Poland 2014BARRERA CORDERO Alberto Spain 2005BARRY James United Kingdom 2012BASTANI Hamid Sweden 2015BASTIAN Dirk Germany 2014BAUERNFEIND Tamas Hungary 2013BAYRAK Duhan Fatih Belgium 2011BEAUPORT Joelle Germany 2012BEDNAREK Jacek Poland 2011BEHAR Nathalie France 2014BELOTTI Giuseppina Italy 2006BENCARDINO Gianluigi Italy 2015BENCSIK Gabor Hungary 2009BENEZET MAZUECOS Juan Spain 2014BENITO MARTIN Eva Maria Spain 2015BERRUEZO SANCHEZ Antonio Spain 2006BERTAGNOLLI Livio Italy 2013BERTERO Giovanni Italy 2012BERTOMEU-GONZALEZ Vicente Spain 2010



BIANCHI Francesca Italy 2014BISBAL Felipe Belgium 2014BLAAUW Yuri Netherlands 2011BLANDINO Alessandro Italy 2013BOGDAN Stefan Nicolae Romania 2014BOHORA Shomu India 2012BONANNO Carlo Italy 2011BORDIGNON Stefano Italy 2013BOROV Stefan Bulgaria 2015BORREGO BERNABE Luis Spain 2013BOTROS Maichel Sobhy Naguib Egypt 2014BOULLIN Julian Paul United Kingdom 2010BROCKMEIER Johannes Paul Germany 2013BROUZET Thomas Spain 2012BRUGADA Josep Spain 2007BUCHHOLZ Jochen Germany 2013BUERKLE Gerd Austria 2008BUIATTI Alessandra Italy 2015BUN Sok-Sithikun France 2012BURKHARDT Dietmar Germany 2014BURRI Haran Switzerland 2007CABANAS GRANDIO Pilar Spain 2014CABRERA GOMEZ Sandra Spain 2014CALVANESE Raimondo Italy 2014CALVO CUERVO David Spain 2010CALVO GALIANO Naiara Spain 2011CAMPOS GARCIA Bieito Spain 2010CAÑADAS GODOY Maria Victoria Spain 2013CANO PEREZ Oscar Spain 2009CARBALLEIRA Lidia Spain 2015CASADO ARROYO Ruben Spain 2015CASTAGNO Davide Italy 2015CASTILLO Jesús Spain 2013CASTREJON CASTREJON Sergio Spain 2012CASTRO FIGUEROA Lena Del Pilar Spain 2015CASTRO URDA Victor Spain 2009CATANCHIN Andrei Australia 2008CHALDOUPI Sevasti-Maria Netherlands 2015CHAPURNYKH Alexander Russia 2015CHATTERJEE Debjit United Kingdom 2010CHONG Daniel Singapore 2011CIPOLLETTA Laura Italy 2015CISMARU Gabriel Romania 2015CLEMENS Marcell Hungary 2012CLEMENTY Nicolas France 2010CONTE Giulio Italy 2015CONTI Sergio Italy 2015CORTEZ-DIAS Nuno Portugal 2013COSTA Alessandro Italy 2015COZAR LEON Rocio Spain 2011

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DAR Mehboob Saudi Arabia 2013DATINO Tomas Spain 2011DAVOODI Gholamreza Ireland 2007DE DIEGO Carlos Spain 2012DE FILIPPO Paolo Italy 2011DE GROOT Joris R. Netherlands 2009DE JONG Jonas Netherlands 2011DE LUCIA Raffaele Italy 2015DE MEYER Grim Belgium 2011DE RIVA SILVA Marta Spain 2011DEL CASTILLO ARROJO Silvia Spain 2006DELCOUR Alexandre Belgium 2015DELGADO Hugo Emilio Argentina 2013DEUTSCH Alexandru Romania 2009DI CORI Andrea Italy 2012DICHTL Wolfgang Austria 2011DINOV Borislav Germany 2012DJAJADISASTRA Achmad Iskandar Germany 2011DOMINGUEZ MAFE Eloy Spain 2012DURAY Gabor Zoltan Germany 2008DUTHOIT Guillaume France 2010DYRDA Katia Canada 2010EIJSBOUTS Sabine Netherlands 2014EISENBERGER Martin Czech Republic 2008EL KADRI Moutaz United Kingdom 2012EL MAGHAWRY Mohamed Egypt 2015ELDER Douglas United Kingdom 2010ELICES TEJA Juliana Spain 2015ESTRADA Alejandro Spain 2013EVERTZ Reinder Netherlands 2014EWERTSEN Niels Christian Germany 2013EXPOSITO Victor Spain 2015FERNANDEZ LOZANO Ignacio Spain 2005FERNANDEZ PASTOR Julia Spain 2012FICHTNER Stephanie Germany 2014FIGUEROA Jorge Alejandro Argentina 2014FILGUEIRAS RAMA David Spain 2012FONTENLA Adolfo Spain 2010FORCLAZ Andrei Switzerland 2009FOSCH Javier Spain 2013FRANCK Harald Germany 2010FRANCO DIEZ Eduardo Spain 2015FRANZINI Christine Switzerland 2014FUKUNAGA Masato Czech Republic 2015GALLARDO LOBO Rodrigo Spain 2009GANDJBAKHCH Estelle France 2013GARCIA MORAN Emilio Spain 2005GAROFALO FORTE Daniel Spain 2013GAWRYSIAK Marcin Poland 2009GLOWNIAK Andrzej Poland 2009



GODA Sherif Egypt 2014GOMEZ Federico Spain 2014GONZALEZ FERRER Juan Jose Spain 2012GONZALEZ VASSEROT Maria Del Mar Spain 2007GONZALEZ-ENRIQUEZ Susana Spain 2008GOPALAMURUGAN A. B. United Kingdom 2011GOURRAUD Jean Baptiste France 2014GRANIER Mathieu France 2011GRECU Mihaela Romania 2006GRIECO Domenico Italy 2014GRUBB Neil United Kingdom 2014GUENANCIA Charles France 2015GUGUCHEV Pavel United States Of America 2010GUY-MOYAT Benoit France 2010HAGGUI Abdeddayem Tunisia 2015HEMELS Martin Netherlands 2011HENDRICKS Neil South Africa 2012HENKENS Ivo Netherlands 2015HERCZKU Csaba Hungary 2009HERREROS GUILARTE Benito Spain 2005HLIVAK Peter Slovakia 2010HOBBS William Julian United Kingdom 2007HOFFMANN Andrzej Poland 2012HOGLUND Niklas Sweden 2008HOOFT VAN HUYSDUYNEN Bart Netherlands 2011HORDYNSKI Grzegorz Poland 2012HUEMER Martin Germany 2013HUYBRECHTS Wim Belgium 2008IATROPOULOS Dimitrios Greece 2015IMNADZE Guram Germany 2015INFUSINO Tommaso Italy 2011IORGULESCU Corneliu-Nicolae Romania 2012JAN Matevz Slovenia 2014JANDA Igor Germany 2009JANSEN Ward Netherlands 2009JARMAN Julian United Kingdom 2012JASTRZEBSKI Marek Poland 2007JAUREGUI ABULARACH Miguel Eduardo Spain 2010JILEK Clemens Germany 2011JIMENEZ JAIMEZ Juan Spain 2013JIMENEZ LOPEZ Jesús Spain 2015JIMENEZ-DIAZ Javier Spain 2013JOHAR Sofian United Kingdom 2009JONES David Gareth United Kingdom 2009JOST Colin Germany 2012JULIA CALVO Justo Spain 2015KACZMAREK Krzysztof Poland 2010KANDIL Mehmet Germany 2011KARDOS Attila Hungary 2010KEMME Michiel The Netherlands 2008

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KILISZEK Marek Poland 2009KIRUBAKARAN Senthil United Kingdom 2012KOCH Lydia Germany 2012KONRAD Torsten Germany 2014KONSTANTINIDOU Melanie Germany 2011KONTOGEORGIS Andrianos United Kingdom 2015KOOPMAN Pieter Belgium 2011KOSTOPOULOU Anna Greece 2012KOX Thomas Germany 2015KRISTENSEN Jens Denmark 2013KRIVOLAPOV Sergey Russia 2013KUHNE Michael Switzerland 2011KUMAR Narendra Netherlands 2015KUPICS Kaspars Latvia 2015LALLEMAND Benedicte France 2012LANG Christopher United Kingdom 2012LANGBEIN Anke Germany 2014LAURENZI Francesco Italy 2008LE POLAIN DE WAROUX Jean-Benoit Belgium 2012LERCHER Peter Austria 2010LETSAS Konstantinos Greece 2008LEVENTOPOULOS Georgios Greece 2014LINDE Antonio Spain 2013LOUW Ruan South Africa 2014LUBINSKI Andrzej Poland 2005LUEDORFF Guido Germany 2012LUERMANS Justin Netherlands 2013LUQUE Antonio Spain 2014MADRAZO DELGADO Ines Spain 2012MADRID Antonio Spain 2008MAKOWSKI Karol Portugal 2010MANTZIARI Aglaia-Angeliki (Lilian) United Kingdom 2013MANUSAMA Randy Netherlands 2015MARINI Massimiliano Italy 2010MARTINEK Martin Austria 2008MARTINEZ ALDAY Jesus Daniel Spain 2005MARTINEZ SANDE Jose Luis Spain 2009MASSIN Francois France 2009MATIA FRANCES Roberto Spain 2009MATIELLO Maria Spain 2007MAZUR Alexander Israel 2005MCCREADY James United Kingdom 2010MEJIA Elena Spain 2014MELLOR Greg United Kingdom 2013MEYER Christian Germany 2011MOISEI Radu Eugen Romania 2015MOLATTA Stephan Germany 2015MORENO Jose Spain 2013MORENO REVIRIEGO Sara Spain 2011MOYA I MITJANS Angel Spain 2005



MUELLER Dirk Germany 2008MUELLER Stephan Andreas Switzerland 2011MUNDEL Markus Germany 2011MUNOZ ESPARZA Carmen Spain 2015MUNTEAN Bogdan Germany 2013NAGEH-ARMANIOS Maged United States Of America 2010NAVARRETE CASAS Antonio Javier United States Of America 2007NAVARRO Javier Spain 2012NENTWICH Karin Germany 2012NG Fu Siong United Kingdom 2014NOTI Fabian Switzerland 2013NOVAK Jan United Kingdom 2013OLORIZ SANJUAN Teresa Spain 2013ORMAETXE MERODIO Jose Miguel Spain 2005OSCA ASENSI Joaquin Spain 2006ÖZCAN Emin Evren Turkey 2013PACHON Marta Spain 2011PADFIELD Gareth United Kingdom 2013PAISEY John United Kingdom 2008PANCHETTI Luca Italy 2014PAPIASHVILI Giorgi Georgia 2007PARK Chan-Il Switzerland 2014PASTOR FUENTES Agustin Spain 2005PAURIAH Maheshwar United Kingdom 2012PAVACI Herribert Germany 2015PAVLOVIC Nikola Croatia 2014PAWLIK Tomasz Poland 2013PEINADO Rafael Spain 2005PELAEZ GONZALEZ Antonio Spain 2012PENELA Diego Spain 2014PEREZ Armando Spain 2010PEREZ ALVAREZ Luisa Spain 2011PEREZ CASTELLANO Nicasio Spain 2005PEREZ DIEZ Diego Spain 2010PEREZ-VILLACASTIN Julian Spain 2005PERROTTA Laura Italy 2014PEZAWAS Thomas Austria 2015PIQUERAS Eric France 2015PISON Laurent Netherlands 2010POELSLER Robert Germany 2014POOSAPADDI RAJA Bhima Shankar India 2012POZZETTI Daniela Italy 2007PRISECARU Raluca Belgium 2015PUCHOL Alberto Hungary 2009QURESHI Norman United Kingdom 2013RACKAUSKAS Gediminas Lithuania 2015RAJU Hariharan United Kingdom 2015RAMANNA Hemanth The Netherlands 2008REBELLATO Luca Italy 2009RENZULLO Elvira Italy 2015

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RIAHI Leila Tunisia 2013RICCIARDI Danilo Belgium 2012RICCIARDI Giuseppe Italy 2015RISTIC Velibor Serbia 2015RIVAS GANDARA Nuria Spain 2010RIVERA Santiago Canada 2013ROCA LUQUE Ivo Spain 2011ROCHA COSTA Sergia Portugal 2015RODRIGUEZ MANERO Moises Belgium 2012RORDORF Roberto Italy 2009ROSER Mattias Germany 2012ROSSI Andrea Italy 2011ROSSI Luca Italy 2012ROTEN Laurent Switzerland 2008ROUX Antoine France 2010RUBIO Jose Manuel Spain 2015SABATE DE LA CRUZ Xavier Spain 2005SALGADO ARANDA Ricardo Spain 2013SALGUERO BODES Rafael Spain 2007SALMAS Jozef Germany 2015SAMMUT Mark Adrian Malta 2012SAMO AYOU Romeo Sweden 2010SANCHEZ BORQUE Pepa Spain 2015SANCHEZ GOMEZ Juan Miguel Spain 2013SANDILANDS A. United Kingdom 2010SANZO Antonio Italy 2014SARRIAS Axel Spain 2013SAUSE Armin Germany 2008SAYGI Serkan Turkey 2015SCHERR Daniel Austria 2013SCHIMPF Rainer Germany 2012SCHOENBAUER Robert Austria 2011SCHOONDERWOERD Bas Netherlands 2008SEBAG Frederic France 2014SEGRETI Luca Italy 2010SEGURA VILLALOBOS Federico Spain 2011SEILER Jens Switzerland 2010SEOW Swee-Chong Singapore 2007SERVATIUS Helge Switzerland 2014SGARITO Giuseppe Italy 2012SIEIRA RODRIGUEZ-MORET Juan Antonio Spain 2014SIELSKI Slawomir Poland 2007SILBERBAUER John United Kingdom 2013SILISTE Calin Italy 2011SKENE Christopher United Kingdom 2013SKODA Jan Czech Republic 2008SMIT Jaap Jan The Netherlands 2008SOHAL Manav United Kingdom 2015SONNE Kai Germany 2015SORREL Jeremie France 2015



SPADACINI Gianmario Italy 2006STANLEY Anthony South Africa 2012STEC Sebastian Poland 2014STEFFEL Jan Switzerland 2012STOECKEL Holger Switzerland 2012STUEHLINGER Markus Austria 2010SUMAN HORDUNA Irina United Kingdom 2008SZABO Albin Arpad Hungary 2010SZEPLAKI Gabor Hungary 2011SZTANISZLAV Aron Hungary 2015TAHAPARY Giovanni Netherlands 2013TAHIN Tamas Hungary 2015TEIJEIRA FERNANDEZ Elvis United Kingdom 2012TEMPLE Ian United Kingdom 2013TER BEKKE Rachel M.A. Netherlands 2013TOMAN Ondrej Czech Republic 2012TOMLINSON D. United Kingdom 2008TONIOLO Mauro Italy 2014TOQUERO RAMOS Jorge Spain 2005TORCIVIA Riccardo Italy 2012TRAN Van Nam Switzerland 2014TRAYKOV Vassil B. Hungary 2010TREGUER Frederic France 2009TRINES Serge Alexander Ivo Petrus Netherlands 2006TRUCCO DE RINAUDO María Emilce Spain 2013TSCHOLL Verena Germany 2015TUOHY Stephen Ireland 2015TURRENI Federico Italy 2014TUTDIBI Osman Germany 2012TUTUIANU Cristina Ioana Romania 2014TZEIS Stylianos Greece 2009UCER Ekrem Germany 2011URBAN Lubos Slovakia 2009VACCARI Diego Italy 2012VALVERDE ANDRE Irene Spain 2010VAN ALEM Anouk Netherlands 2012VAN CASTEREN Lieve Belgium 2010VAN DER HEIJDEN Jeroen Netherlands 2013VAN DIJK Vincent Netherlands 2015VAN HEUVERSWYN Frederic Belgium 2012VAN MALDEREN Sophie Netherlands 2015VAN OOSTROM Antonie Netherlands 2012VAN OPSTAL Jurren Netherlands 2013VANDUYNHOVEN Philippe Belgium 2015VATASESCU Radu-Gabriel Romania 2007VEASEY Rick United Kingdom 2014VEGA OLVERA Mercedes Spain 2012VENABLES Paul United Kingdom 2010VERNOOY Kevin Netherlands 2014VILLANUEVA SANCHEZ José Ginés Spain 2013

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VILLUENDAS SABATE Roger Spain 2010VITALE Raffaele Italy 2009VITALI SERDOZ Laura Italy 2013VOCKE Wolfgang Germany 2010VOSS Frederik Germany 2008VUKAJLOVIC Dejan Germany 2009WATANABE Masaya Netherlands 2014WEBERNDOERFER Vanessa Switzerland 2015WESTRA Sjoerd Netherlands 2012WETZEL Renate Ulrike Germany 2013WIJCHERS Sip Belgium 2012WINTER Siegmund Austria 2010WO Hung-Ta Taiwan 2015WOLF Michael Belgium 2015WYNN Gareth United Kingdom 2014YAMASE Miki Italy 2015YEO Wee Tiong Singapore 2013ZELJKO Hrvojka Marija Croatia 2012ZELLERHOFF Stephan Germany 2011ZHELYAKOV Eugeny Russian Federation 2012ZOPPO Franco Italy 2006ZUBERI Zia United Kingdom 2013ZUCCHELLI Giulio Italy 2008

Cardiac Pacing & Device Therapy EHRA CP Certified professionals

AARDEMA Margriet W. Netherlands 2014ACENA RAMOS Marta Spain 2012ACOU Willem-Jan Belgium 2014ADIYAMAN Ahmet Netherlands 2014AL BUNNI Muhamad Italy 2007ALCALDE RODRIGUEZ Oscar Spain 2012AL-HASHIMI Hisham Netherlands 2015ALZAND Bakr Netherlands 2012ANNE Wim Belgium 2011APOSTOLOPOULOS Theodoros Greece 2007ARBELO Elena Spain 2013ARIAS PALOMARES Miguel Angel Spain 2013AVELLA Andrea Italy 2005AYALA PAREDES Felix Alejandro Canada 2009AZEM Tareq Germany 2015BACCHIONI Giuseppe Italy 2012BAHGAT Amr Kamal Egypt 2012BALT Jippe Netherlands 2014BALTA Osman Germany 2013BAYRAK Duhan Fatih Belgium 2012BELOTTI Giuseppina Italy 2005BENCSIK Gabor Hungary 2009


EHRA CP Certified professionals

BERTOMEU-GONZALEZ Vicente Spain 2012BIJSTERVELD Nick Netherlands 2012BISSINGER Andrzej Poland 2007BLAAUW Yuri Netherlands 2012BLICHARZ Jaroslaw Poland 2015BOHM Adam Hungary 2009BONANNO Carlo Italy 2014BOOS Christopher United Kingdom 2009BORGER VAN DER BURG Alida Elisabeth Netherlands 2009BORRELLI Alessio Italy 2012BORRELLO Francesco Italy 2013BOUWELS Leon H.R. Netherlands 2009BREULS Nico The netherlands 2010BROERS Bernard The netherlands 2010BUERKLE Gerd Austria 2012BUN Sok-Sithikun France 2013BURRI Haran Switzerland 2005CALVO CUERVO David Spain 2013CALZOLARI Vittorio Italy 2007CANADAS Victoria Spain 2013CARAVATI Fabrizio Italy 2012CASSIDY Christopher John United Kingdom 2015CHATTERJEE Debjit United Kingdom 2013CHONG Daniel Singapore 2013CHONG YU Eric Singapore 2013CHRISTOPHE Arnd Germany 2014CHRISTOU Apostolos Greece 2015CIPOLLETTA Laura Italy 2014CLEMENS Marcell Hungary 2015CROSATO Martino Italy 2009CURNIS Antonio Italy 2007DAVID Laura-Alice Romania 2015DAVOODI Gholamreza Iran (Islamic Republic of) 2005DE DOELDER Marieke Netherlands 2012DE GROOT Joris R. Netherlands 2011DE JONG Jonas Netherlands 2012DE LA FUENTE Sam The netherlands 2010DE MEYER Grim Belgium 2013DE SENSI Francesco Italy 2015DI CORI Andrea Italy 2015DICHTL Wolfgang Austria 2012DIJKMAN Barbara Netherlands 2015DILAVERIS Polychronis Greece 2007DINH Trang Netherlands 2013DOMENICHINI Giulia Spain 2014DORMAN Reinhart Netherlands 2013DULBECCO Massimo Italy 2013DURAY Gabor Zoltan Germany 2008DYRDA Katia Canada 2012EHRLICH Joachim Germany 2012

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EIJSBOUTS Sabine Netherlands 2015EISENBERGER Martin Czech republic 2011EIVINDSON Gunvald Norway 2009EL KADRI Moutaz United Kingdom 2013ENGBERS Jos G. The netherlands 2011ESCHEN Ole Denmark 2012EVERTZ Reinder Spain 2012FACCHIN Domenico Italy 2013FERNANDEZ PASTOR Julia Spain 2012FERNANDEZ-ARMENTA PASTOR Juan Spain 2015FIROUZI Mehran Netherlands 2015FOLDESI Csaba Laszlo Hungary 2012FOLEY Paul United Kingdom 2012FOLKERINGA Richard Netherlands 2009FONTENLA Adolfo Spain 2012FRANCK Harald Germany 2011FRANCOIS Bart Belgium 2012FRANZINI Christine Switzerland 2015FURNISS Guy United Kingdom 2015GALLARDO LOBO Rodrigo Spain 2012GARCIA BOLAO Jose Ignacio Spain 2005GARWEG Christophe Belgium 2014GERRITSEN Jean Georges Netherlands 2013GHANI Abdul Netherlands 2012GIANNOLA Gabriele Italy 2012GIL Ricardo Portugal 2013GIL ORTEGA Ignacio Spain 2013GJESTVANG Finn Tore Norway 2009GONZALEZ-ENRIQUEZ Susana Spain 2013GRADAUS Rainer Germany 2007GRECU Mihaela Romania 2009GRIECO Domenico Italy 2014HAMEL John John Switzerland 2011HARTOG Jasper Netherlands 2015HASSINK Rutger Netherlands 2015HAUER Herbert Netherlands 2012HAUER Arnaud Netherlands 2015HAYES Chris United Kingdom 2012HAZELEGER Ronald Netherlands 2012HEIB Klausdieter Germany 2010HEMELS Martin Netherlands 2012HERCZKU Csaba Hungary 2012HERREROS GUILARTE Benito Spain 2005HJORTSHOJ Soren Denmark 2010HOBBS William Julian United Kingdom 2013HORDYNSKI Grzegorz Poland 2011HORNSTEN Jonas Sweden 2007HURLIMANN David Switzerland 2012HUYBRECHTS Wim Belgium 2010IONNIDIS Panagiotis Greece 2007



IORGULESCU Corneliu Romania 2012JACON Peggy France 2012JAMALYAN Smbat Armenia 2011JANSEN Ward Netherlands 2010JANSEN Annemieke The netherlands 2011JASTRZEBSKI Marek Poland 2007JILEK Clemens Germany 2012JOHAR Sofian United Kingdom 2015JONES David Gareth United Kingdom 2012KACZMAREK Krzysztof Poland 2013KARABINOS Ilias K. Greece 2009KEMME Michiel Netherlands 2009KETELS Stefan Belgium 2009KLAUSZ Gergely Hungary 2015KLEIN Gunnar Germany 2007KLEIN Norbert Germany 2013KOEPFLI Pascal Switzerland 2010KOEPP Ulf Norway 2009KOOPMAN Pieter Belgium 2014KORANTZOPOULOS Panagiotis Greece 2011KOSTOPOULOU Anna Greece 2012KOULOURIS Spyridon Greece 2010KOUROUKLIS Spyridon Greece 2012KRAVCHUK Borys Ukraine 2012KRISTENSEN Jens Denmark 2013KRUPA Wojciech Poland 2010LANGERAK Susan Netherlands 2013LERCHER Peter Austria 2013LEWANDOWSKI Michael Poland 2015LEWANDOWSKI Michael Poland 2015LINDE Antonio Spain 2015LIPCHENCA Igor Ariel Israel 2009LIPTON Jonathan Netherlands 2015LITTERFELDT Ingrid Sweden 2011LOUW Ruan Belgium 2014LUBBERTVERBERKMOES Addy Netherlands 2013LUEDORFF Guido Germany 2009LUERMANS Justin Netherlands 2014LUTHJE Lars Germany 2013MAC GILLAVRY Melvin The netherlands 2011MACIAG Aleksander Poland 2009MADEIRA Joao Portugal 2012MARGULESCU Andrei Dumitru Romania 2014MARINI Massimiliano Italy 2008MARTINEK Martin Austria 2010MARTINEZ SANDE Jose Luis Spain 2012MASCIOLI Giosue Italy 2007MASSA Thomas Germany 2011MAXIM George Razvan Romania 2015MEINE Mathias Netherlands 2010

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MERKELY Bela Hungary 2007MICHAELSEN Jochen Germany 2011MITKOWSKI Przemyslaw Poland 2005MOLLNAU Hanke Germany 2014MONNINK Stefan Netherlands 2012MORENO Jose Spain 2015MORENO PLANAS Javier Spain 2005MORTSELL David Sweden 2013MUELLER Stephan Andreas Switzerland 2014MUNDEL Markus Germany 2011MUNTINGA Harm-Jans Netherlands 2012NAGEH-ARMANIOS Maged United States of America 2015NENTWICH Karin Germany 2013NEVEN Kars Netherlands 2008NOVAK Jan Switzerland 2013NOVIKOV Dmitry Russian Federation 2013OMAR Salama Egypt 2012OOMEN Ad Netherlands 2015OREZIAK Artur Poland 2015ORSIDA Daniela Italy 2014OSMAN Faizel United Kingdom 2007OSZTHEIMER István Hungary 2015OUSS Alexandre Netherlands 2014PADFIELD Gareth United Kingdom 2015PATWALA Ashish United Kingdom 2012PAULUSSEN Guido Netherlands 2007PENA HERNANDEZ Jose Luis Spain 2011PEREZ ALVAREZ Luisa Spain 2013PEREZ CASTELLANO Nicasio Spain 2005PEREZ DIEZ Diego Spain 2012PERNA Francesco Italy 2015PETRACCI Barbara Italy 2012PETTIT Stephen United Kingdom 2013PINDADO RODRIGUEZ Javier Spain 2010PLUTA Slawomir Poland 2012POELSLER Robert Germany 2013PORRO Rosa Spain 2010POZZETTI Daniela Italy 2007PREDOVSKI Milen Bulgaria 2013PRISECARU Raluca Belgium 2015PROIETTI Riccardo Italy 2014PRUSKI Maciej Poland 2013PRZYBYLSKI Andrzej Poland 2008PUCHOL Alberto Spain 2012PUGH Peter United Kingdom 2009PYATT Jason United Kingdom 2012RAO Archana United Kingdom 2009RASSIAS Ioannis Greece 2014REBELLATO Luca Italy 2012RESTLE Christian Germany 2013



RICCIARDI Danilo Belgium 2013RIENSTRA Michiel Netherlands 2014RIVAS GANDARA Nuria Spain 2013ROBERT Jens Switzerland 2014ROBLES DE MEDINA Ramon Mariano Netherlands 2015ROCA LUQUE Ivo Spain 2015RODRIGUEZ MANERO Moises Belgium 2013RORDORF Roberto Italy 2014ROSA Antonio Switzerland 2013ROSSI Andrea Italy 2014ROTEN Laurent Switzerland 2009ROUKAS Kriton-Ioannis Greece 2012ROUX Antoine France 2013RUZICKA Petr United Kingdom 2013SAFAK Erdal Germany 2014SALGADO ARANDA Ricardo Spain 2014SCHÄR Beat Andreas Switzerland 2013SCHAUMANN Anselm Germany 2012SCHEFFER Michael G. The netherlands 2011SCHOONDERWOERD Bas Netherlands 2012SCHREVE-STEENSMA Ariadne Midori Netherlands 2014SEDLACEK Kamil Czech Republic 2013SEGRETI Luca Italy 2013SEGURA VILLALOBOS Federico Spain 2012SEILER Jens Switzerland 2013SEMICHON Marc France 2014SEOW Swee-Chong Singapore 2008SEPSI Milan Czech Republic 2014SGARITO Giuseppe Italy 2007SIMEONIDOU Eftihia Greece 2007SJOBLOM Johanna Sweden 2009SKENE Chris United Kingdom 2014SKIADAS Ioannis Greece 2012SMILDE Tom Netherlands 2012SONESSON Linus Sweden 2014SPIERENBURG Han The netherlands 2009STATESCU Cristian Romania 2012STEEN Torkel Norway 2013STEFAN Liliana Czech Republic 2012STEFAN NICOLEA Bogdan Romania 2012STEFFEL Jan Switzerland 2012STERLINSKI Marciej Poland 2009STOCKBURGER Martin Germany 2012STOECKEL Holger Switzerland 2015STRANDERS Ischa Netherlands 2015STUEHLINGER Markus Austria 2012SZAMLEWSKI Piotr Sweden 2011TAHAPARY Giovanni The netherlands 2013TEIJEIRA FERNANDEZ Elvis Spain 2014TER BEKKE Rachel The netherlands 2013

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TIELEMAN Robert Netherlands 2012TIMMERS Liesbeth Belgium 2015TIMMERS Liesbeth Belgium 2015TORCIVIA Riccardo Italy 2012TORN Marieke The Netherlands 2012TRAYKOV Vassil B. Bulgaria 2011TRUCCO Maria Emilce Spain 2015TUINENBURG Anton Netherlands 2013TUININGA Ype The netherlands 2011TUREL Baybars Turkey 2012TURK Ugur Onsel Turkey 2015TUTUIANU Cristina Ioana Romania 2015UCER Ekrem Germany 2012VACCARI Diego Italy 2007VALK Suzanne Netherlands 2011VALZANIA Cinzia Italy 2010VAMOS Mate Hungary 2014VAN ALEM Anouk Netherlands 2013VAN CASTEREN Lieve Belgium 2011VAN DEN AKKER-BERMAN Lily Netherlands 2015VAN DEN BOS Ewoutjan The netherlands 2011VAN DEN BRINK Olivier Wv Netherlands 2014VAN DER HEIJDEN Robert Netherlands 2011VAN DER HEIJDEN Dirk Netherlands 2011VAN DER HEIJDEN Jeroen Netherlands 2013VAN DIJK Vincent Netherlands 2015VAN DOORN Dirk Jan Netherlands 2015VAN HEUVERSWIJN Frederic Belgium 2015VAN KRAAIJ Dave The netherlands 2010VAN MALDEREN Sophie C.H. Belgium 2015VAN OOSTROM Antonie Netherlands 2012VAN OPSTAL Jurren Netherlands 2009VAN REIJ Frank Netherlands 2012VAN ROOSMALEN Radboud Netherlands 2015VAN SCHAARDENBURGH Pepijn The netherlands 2012VAN VLIES Bob Netherlands 2013VAN WOERKENS Leon Netherlands 2012VASILOPOULOS Charalambos Greece 2007VATASESCU Radu- Gabriel Romania 2007VENABLES Paul United Kingdom 2013VERGARA Pasquale Italy 2010VERNOOY Kevin Netherlands 2013VET Thijs The netherlands 2011VIERGEVER Eric Paul Netherlands 2012VILLUENDAS SABATE Roger Spain 2013VOLKOV Dmytro Ukraine 2015VOSS Frederik Germany 2009VRAZIC Hrvoje Croatia 2014WESTENDORP Iris Netherlands 2009WESTRA Sjoerd Netherlands 2012



WETZEL Ulrike Renate Germany 2015WIJCHERS Sip Belgium 2012WILLEMS Albert Richard Netherlands 2012WOLF Michael Belgium 2015WOLLMANN Christian Austria 2012YAP Sing-Chien Netherlands 2014YEO Wee Tiong Singapore 2014ZAKY Hosam United Arab Emirates 2007ZALEVSKY Valery P. Ukraine 2011ZELJKO Hrvojka Marija Croatia 2015ZERVOPOULOS George Greece 2007ZIMA Endre Hungary 2012ZOPPO Franco Italy 2007ZUCCHELLI Giulio Italy 2012

CP Certification candidates who have successfully completed the exam

AARDEMA Margriet W. Netherlands 2006ABRAHAM Pal Hungary 2011ACENA RAMOS Marta Spain 2010ACOU Willem-Jan Belgium 2011ADDONISIO Luigi Italy 2012ADIYAMAN Ahmet Netherlands 2014AERTS Arnaud The Netherlands 2009AKERSTROM Finn Sweden 2015AL AMOURA Alaa France 2015AL ANANY Alaa Allah Mohamed Egypt 2013AL BUNNI Muhamad Italy 2006ALBERTSEN Andi Eie Denmark 2010ALCALDE RODRIGUEZ Oscar Spain 2010ALDERGARD Niklas Sweden 2007ALDHOON Bashar Czech Republic 2011ALGALARRONDO Vincent France 2009AL-HASHIMI Hisham Netherlands 2011ALIYEV Farid Turkey 2010ALIZADEH DEHNAVI Reza Netherlands 2013ALMEIDA Sofia Portugal 2014ALZAND Bakr Netherlands 2011AMET Denis France 2011AMMON Michael Switzerland 2014ANDERSON Mark H United Kingdom 2012ANGHEBEN Carlo Italy 2015ANNE Wim Belgium 2008ANSABERGA Leva Latvia 2015APOSTOLOPOULOS Theodoros Greece 2006ARBELO Elena Spain 2012ARGUEDAS-JIMENEZ Hugo Spain 2015ARIAS PALOMARES Miguel Angel Spain 2010ARNOLD Alfred E. R. Netherlands 2012

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ARO Aapo Finland 2013ARVANITIS Panagiotis Sweden 2015ASSAAD Hany Egypt 2015ASSELMAN Maarten Netherlands 2012AVELLA Andrea Italy 2005AYALA PAREDES Felix Alejandro Canada 2006AYDIN Alper Turkey 2014AZEM Tareq Germany 2013BACCHIONI Giuseppe Italy 2008BADRAN Haitham Egypt 2013BAHGAT Amr Kamal Egypt 2009BALMER Christian Switzerland 2013BALT Jippe Netherlands 2011BALTA Osman Germany 2010BARBRAUD Cynthia Belgium 2015BARKER Diane United Kingdom 2011BAROUDI Rabah France 2014BARSAMIAN Sergei Armenia 2013BARTHEZ Olivier France 2009BAYRAK Duhan Fatih Belgium 2011BEAUPORT Joelle Germany 2012BEDNAREK Jacek Poland 2013BELOTTI Giuseppina Italy 2005BELVITO Chiara Italy 2013BENCSIK Gabor Hungary 2008BENEZET MAZUECOS Juan Spain 2014BENNIK Jasper Netherlands 2015BERENJKOUB Ehssan Germany 2015BERGNER Michael Switzerland 2015BERLI Reto Switzerland 2015BERTE Benjamin Belgium 2012BERTOMEU-GONZALEZ Vicente Spain 2010BEUKEMA Rypko Netherlands 2015BHELEEL Osama Libya 2013BIANCHI Francesca Italy 2015BIANCO Daniele Italy 2015BIJSTERVELD Nick Netherlands 2009BISH Laurence Switzerland 2015BISSINGER Andrzej Poland 2006BLAAUW Yuri Netherlands 2009BLANDINO Alessandro Italy 2015BLICHARZ Jaroslaw Poland 2011BLOMGREN Jan Sweden 2012BOHM Adam Hungary 2008BOLOGNESI Maria Giulia Italy 2015BON Laurens Bastiaan Netherlands 2015BONANNO Carlo Italy 2012BONCOMPAGNI Andrea Italy 2014BOOS Christopher United Kingdom 2008BORGER VAN DER BURG Alida Elisabeth Netherlands 2007



BORGHOUTS Virginie Netherlands 2014BORGQUIST Rasmus Sweden 2013BORLEFFS Jan Willem Netherlands 2015BORREGO BERNABE Luis Spain 2013BORRELLI Alessio Italy 2009BORRELLO Francesco Italy 2013BOS Hans Netherlands 2012BOSKER Hans Netherlands 2012BOULE Stéphane France 2015BOUWELS Leon H.R. Netherlands 2007BRAAM Richard Netherlands 2010BREULS Nico The Netherlands 2009BROERS Bernard The Netherlands 2009BRONIS Konstantinos United Kingdom 2015BUERKLE Gerd Austria 2008BUGA Laszlo United Kingdom 2012BULUT Suat Netherlands 2010BUN Sok-Sithikun France 2012BURKART-KUETTNER Dagmar Austria 2015BURRI Haran Switzerland 2005BUSER Marc Switzerland 2015CABANAS GRANDIO Pilar Spain 2014CACKO Andrzej Poland 2015CALVO CUERVO David Spain 2010CALZOLARI Vittorio Italy 2006CAMPOS GARCIA Bieito Spain 2010CANADAS Victoria Spain 2010CANDEIAS Rui Portugal 2008CARAVATI Fabrizio Italy 2010CARBALLEIRA POL Lidia Spain 2015CARROZ Patrice Switzerland 2015CASSIDY Christopher John United Kingdom 2014CASTREJON CASTREJON Sergio Spain 2013CHAMBERS John United Kingdom 2013CHATEL Marie Pierre France 2015CHATTERJEE Debjit United Kingdom 2010CHENEVARD Remy Switzerland 2012CHONG Daniel Singapore 2011CHONG YU Eric Singapore 2013CHRISTOPHE Arnd Germany 2011CHRISTOU Apostolos Greece 2014CIPOLLETTA Laura Italy 2014CLAPPERS Nick Netherlands 2014CLEMENS Marcell Hungary 2012CORTEVILLE Ben Belgium 2015COSER Alessio Italy 2011CROSATO Martino Italy 2008CSONTOS Pal Hungary 2009CURNIS Antonio Italy 2006DAVID Laura-Alice Romania 2012

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DAVIDSEN Ulla Denmark 2015DAVIES Edward United Kingdom 2015DAVOODI Gholamreza Iran (Islamic Republic Of) 2005DE CLERCQ An Netherlands 2013DE DIEGO RUS Carlos Spain 2013DE DOELDER Marieke Netherlands 2010DE GROOT Joris R. Netherlands 2009DE GROOT Cornelis Andreas Netherlands 2012DE JONG Jeroen Netherlands 2006DE JONG Richard M. Netherlands 2007DE JONG Jonas Netherlands 2009DE LA FUENTE Sam The Netherlands 2009DE LEEUW Martin The Netherlands 2008DE LUCIA Raffaele Italy 2014DE MARIA Elia Italy 2012DE MEYER Grim Belgium 2010DE POOTER Jan Belgium 2015DE POTTER Tom Belgium 2008DE RIVA SILVA Marta Spain 2011DE SENSI Francesco Italy 2013DE TOMMASI Francesco Italy 2015DE WAARD Daan Netherlands 2007DE WEERD Gerjan The Netherlands 2009DEIß Michael Germany 2015DEMONIERE Fabrice Martinique 2011DERNDORFER Michael Austria 2013DI CORI Andrea Italy 2012DI STOLFO Giuseppe Italy 2015DIAB Ihab Gomaa United Kingdom 2009DIAZ BUSCHMANN Isabel Spain 2011DICHTL Wolfgang Austria 2010DIDENKO Maxim Roumania 2010DIJKMAN Barbara Netherlands 2012DILAVERIS Polychronis Greece 2006DILLIER Roger Switzerland 2015DINH Trang Netherlands 2012DOMENICHINI Giulia Spain 2011DORMAN Reinhart Netherlands 2012DULBECCO Massimo Italy 2010DUNCKER David Germany 2013DURAY Gabor Zoltan Germany 2008DUSCEAC Dinu Sweden 2014DUTHOIT Guillaume France 2010DYRDA Katia Canada 2010EHL Niklas Florestan Switzerland 2014EHRLICH Joachim Germany 2011EIJSBOUTS Sabine Netherlands 2011EISENBERGER Martin Czech Republic 2008EIVINDSON Gunvald Norway 2008EL KADIKI Abdelhadi Lebanon 2014



EL KADRI Moutaz United Kingdom 2012ELDER Douglas United Kingdom 2010ELICES TEJA Juliana Spain 2013ENGBERS Jos G. The Netherlands 2009ERCKERT Martin Italy 2006ERIKSEN Ulrik Hedegaard Denmark 2011ERNTELL Hans Sweden 2011ESCHEN Ole Denmark 2009ESMAIL Shani United Kingdom 2011EURLINGS Luc Netherlands 2014EVERTZ Reinder Spain 2012EXPOSITO Victor Spain 2013FACCHIN Domenico Italy 2010FEDORCO Marian Czech Republic 2011FERNANDEZ LOZANO Juan Antonio Spain 2013FERNANDEZ PASTOR Julia Spain 2011FERNANDEZ-ARMENTA PASTOR Juan Spain 2014FIROUZI Mehran Netherlands 2011FLEVARI Panayota Greece 2008FOLDESI Csaba Laszlo Hungary 2009FOLEY Paul United Kingdom 2009FOLKERINGA Richard Netherlands 2007FONTENLA Adolfo Spain 2010FRANCA PEREIRA Roberto United States Of America 2007FRANCK Harald Germany 2010FRANCOIS Bart Belgium 2011FRANZINI Christine Switzerland 2014FREUND Niclas Germany 2013FROMMEYER Gerrit Germany 2014FRYKMANN Viveka Sweden 2007FUNK Sabine Switzerland 2010FURNISS Guy United Kingdom 2014GABRIEL Mario Netherlands 2011GALLARDO LOBO Rodrigo Spain 2009GANDJBAKHCH Estelle France 2013GANIERE Vincent Switzerland 2010GARCIA Rodrigue France 2014GARCIA ALMAGRO Francisco Jose Spain 2013GARCIA BOLAO Jose Ignacio Spain 2005GARNIER Fabien France 2013GARWEG Christophe Belgium 2011GEBETSBERGER Franz Austria 2008GERMANS Tjeerd Morocco 2013GERRITSEN Jean Georges Netherlands 2011GHANI Abdul Netherlands 2012GIANNOLA Gabriele Italy 2008GIL Ricardo Portugal 2010GIL ORTEGA Ignacio Spain 2011GIOMI Andrea Italy 2015GIORGI Davide Italy 2014

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GJESTVANG Finn Tore Norway 2008GOANTA Emilia-Violeta Romania 2015GONZALEZ FERRER Juan Jose Spain 2012GONZALEZ-ENRIQUEZ Susana Spain 2008GORLO Adam Poland 2012GRABOWSKI Marcin Poland 2014GRADAUS Rainer Germany 2006GRAUSS Robert Willem Netherlands 2012GRECU Mihaela Romania 2006GREYLING Adele South Africa 2015GRIECO Domenico Italy 2012GROSFELD Marcel Netherlands 2013GRUBB Neil United Kingdom 2015GRUBER Norbert Germany 2013GUGUCHEV Pavel United States Of America 2010GUSTEU Nicolae-Gabriel Romania 2015GUTLEBEN Klaus Juergen Germany 2011HAEMERS Peter Belgium 2013HAGGUI Abdeddayem Tunisia 2014HAJKO Erik Hungary 2013HAMEL John John Switzerland 2010HAMRAOUI Karim Netherlands 2010HARTOG Johannes Netherlands 2011HARTOG Jasper Netherlands 2014HASSAN Ahmed Abdulwadoud Netherlands 2012HASSINK Rutger Netherlands 2014HAUER Herbert Netherlands 2009HAUER Arnaud Netherlands 2013HAUGAN Ketil Denmark 2014HAWKINS Nathaniel Mark United Kingdom 2012HAYAT Sajad United Kingdom 2012HAYDOCK Paul United Kingdom 2015HAYES Chris United Kingdom 2009HAZELEGER Ronald Netherlands 2010HEGARD Terje Norway 2015HEGGELUND Geir Norway 2013HEIB Klausdieter Germany 2009HELLIGE Gerrit Switzerland 2014HEMELS Martin Netherlands 2009HENKENS Ivo Netherlands 2013HERCZKU Csaba Hungary 2009HERREROS GUILARTE Benito Spain 2005HERRING Neil United Kingdom 2013HERSBACH Ferry Netherlands 2014HERZOG Bernhard Switzerland 2015HJORTSHOJ Soren Denmark 2008HLIVAK Peter Slovak Republic 2013HOBBS William Julian United Kingdom 2010HOEKSTRA Eduard Henk Netherlands 2011HOFFMANN Mario Switzerland 2014



HOLM Katja Fiedler Denmark 2014HOOFT VAN HUYSDUYNEN Bart Netherlands 2010HORDYNSKI Grzegorz Poland 2011HORNSTEN Jonas Sweden 2007HOTTKOWITZ Christoph Switzerland 2015HUANG Sung-Hao China 2014HUEMER Martin Germany 2015HUIJSKES Raymond Netherlands 2012HURLIMANN David Switzerland 2009HUYBRECHTS Wim Belgium 2008IONNIDIS Panagiotis Greece 2006IORGULESCU Corneliu Romania 2008ISAKSEN Tor Olav Norway 2014JACOBSEN Alexander United Arab Emirates 2015JACON Peggy France 2010JAMALYAN Smbat Armenia 2010JANSEN Annemieke The Netherlands 2008JANSEN Ward Netherlands 2010JANSSENS Cornelis Netherlands 2006JARMAN Julian United Kingdom 2012JASTRZEBSKI Marek Poland 2006JAUREGUI ABULARACH Miguel Eduardo Spain 2010JELANI Anwar D. Canada 2010JILEK Clemens Germany 2012JOHANSEN Mette Norway 2014JOHANSSON Peter Sweden 2008JOHAR Sofian United Kingdom 2011JONES David Gareth United Kingdom 2009JONSSON Jon Erik Sweden 2010JUAREZ PRERA Ruben Alfonso Spain 2015KACZMAREK Krzysztof Poland 2010KAHN Matthew United Kingdom 2015KALLIANOS Christos Greece 2011KAMAL Ziaullah Norway 2015KARABINOS Ilias K. Greece 2007KARLSEN Finn Michael Denmark 2015KATARIA Vikas India 2014KATSIKAS Christos Greece 2012KEILEGAVLEN Håvard Norway 2015KEMME Michiel Netherlands 2007KETELS Stefan Belgium 2007KIENCKE Stephanie Switzerland 2015KJELLMAN Bjorn Sweden 2007KLAUSZ Gergely Hungary 2013KLEIN Gunnar Germany 2007KLEIN Norbert Germany 2011KLEIN Lucas Netherlands 2013KNOLL Mathias Germany 2015KNOPS Reinoud The Netherlands 2008KOEPFLI Pascal Switzerland 2007

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KOEPP Ulf Norway 2008KOL Amir Italy 2013KOLB Chistophe Germany 2010KOLLIAS Georgios Greece 2013KOMANOVA Erika Slovak Republic 2011KOOMEN Egbert M. Netherlands 2010KOOPMAN Pieter Belgium 2011KORANTZOPOULOS Panagiotis Greece 2009KORTZ Mikael Netherlands 2010KOSTOPOULOU Anna Greece 2011KOULOURIS Spyridon Greece 2007KOURGIANNIDIS Georgios Greece 2007KOUROUKLIS Spyridon Greece 2011KOUTSOGEORGIS Ilias Greece 2014KOVACS Andras Hungary 2012KRAAIER Karin Netherlands 2015KRAVCHUK Borys Ukraine 2007KRIJNE Rudolf Netherlands 2012KRISTENSEN Jens Denmark 2012KRONBORG Mads Brix Denmark 2011KRUPA Wojciech Poland 2006KRYZE Lukas Czech Republic 2013KRZYZANOWSKI Krystian Poland 2014KUIJPER Aaf Netherlands 2011KUJAWSKI Tomasz Switzerland 2013KUMMER Marco Switzerland 2015KUPICS Kaspars Latvia 2015KWASNIEWSKI Wojciech Poland 2013LAN Rongfang China 2014LANGERAK Susan Netherlands 2012LARGAESPADA PEREZ Gabriel Spain 2015LEBEDEVA Viktoriia Russia 2013LEDEBVRE Kristof Netherlands 2015LENNERZ Carsten Germany 2015LERCHER Peter Austria 2010LERNER Martin Robert Sweden 2010LEVENTOPOULOS Georgios Greece 2014LEWANDOWSKI Michael Poland 2012LIEUW-A-FA Mariska The Netherlands 2009LINDE Antonio Spain 2012LINDELL Peter Sweden 2007LINDGREEN Ulf Denmark 2008LIPCHENCA Igor Ariel Israel 2008LIPOLDOVA Jolana Czech Republic 2009LIPTON Jonathan Netherlands 2012LITTERFELDT Ingrid Sweden 2008LOEPRICH Bruno Germany 2015LOUW Ruan Belgium 2013LUBBERTVERBERKMOES Addy Netherlands 2010LUEDORFF Guido Germany 2008



LUERMANS Justin Netherlands 2012LUNDE Torbjorn Norway 2015LUQUE Antonio Spain 2014LUTHJE Lars Germany 2011LUZI Mario Italy 2008MAASS Alexander Netherlands 2007MAC GILLAVRY Melvin The Netherlands 2008MACIAG Aleksander Poland 2007MADEIRA Joao Portugal 2011MAGNUSSON Peter Sweden 2007MAHFOUD Mohanad France 2010MANENTI Vladimir France 2015MANOLA Sime Croatia 2015MANTZIARI Lilian United Kingdom 2015MANUSAMA Randy Netherlands 2011MARGATO Renato Portugal 2013MARGULESCU Andrei Dumitru Romania 2013MARICONTI Barbara Italy 2008MARINI Massimiliano Italy 2007MARTENS Eimo Germany 2013MARTIN Alix France 2013MARTINEK Martin Austria 2008MARTINEZ SANDE Jose Luis Spain 2009MASCIOLI Giosue Italy 2006MASSA Thomas Germany 2008MATHIEU Frederic Belgium 2015MATTLE Daniel Switzerland 2015MAXIM George Razvan Romania 2014MAZZUCCO Raffaele Italy 2009MEDINA PALOMO Maria Del Carmen Spain 2013MEILTZ Alexandre Switzerland 2009MEINARDI Martin Netherlands 2015MEINDERSMA Esther Netherlands 2013MEINE Mathias Netherlands 2007MELANDER Kjell Sweden 2008MELMAN Paul G. Netherlands 2011MENNE Jochen Germany 2014MERKELY Bela Hungary 2007MICHAELSEN Jochen Germany 2010MICHALAK Marcin Poland 2015MIHALCZ Attila Austria 2011MIRANDA Rita Portugal 2014MISOVOULOS Platon Switzerland 2015MITKOWSKI Przemyslaw Poland 2005MJOLSTAD Ole Christian Norway 2015MLCOCHOVA Hanka Czech Republic 2009MOISEI Radu Eugen Romania 2015MOLHOEK Sander G. The Netherlands 2008MOLLNAU Hanke Germany 2013MONDESERT Blandine Canada 2014

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MONNARD Simon Switzerland 2011MONNINK Stefan Netherlands 2011MOORE Philip R. United Kingdom 2014MORENO Jose Spain 2012MORENO PLANAS Javier Spain 2005MOROSATO Martina Italy 2015MORTSELL David Sweden 2012MORTTADA Ayman Egypt 2012MUELLER Dirk Germany 2008MUELLER Stephan Andreas Switzerland 2011MUELLER Iris Irmgard Germany 2014MUNDEL Markus Germany 2008MUNTEAN Bogdan Germany 2011MUNTINGA Harm-Jans Netherlands 2009MUTSCHELKNAUSS Marcus Switzerland 2013MUTTER Michael Switzerland 2013NAGARAJAN Darbhamulla United Kingdom 2007NAGEH-ARMANIOS Maged United States Of America 2011NENTWICH Karin Germany 2012NERI Gianfilippo Italy 2007NEVEN Kars Netherlands 2007NG Sunanto Netherlands 2011NG KAM CHUEN Marie Jennyfer United Kingdom 2013NICASTIA Deborah The Netherlands 2009NICOLAIDES Eleftherios United Kingdom 2007NIIRANEN Jussi Finland 2015NOTI Fabian Switzerland 2012NOVAK Jan Switzerland 2011NOVIKOV Dmitry Russian Federation 2012NÜSSLI Dominique Switzerland 2013ODLAND Hans Henrik Norway 2009OIKARINEN Lasse Finland 2008OLORIZ Teresa Spain 2015OMAR Salama Egypt 2010OOMEN Ad Netherlands 2011OREZIAK Artur Poland 2011ORSIDA Daniela Italy 2013OSMAN Faizel United Kingdom 2006OSTROWSKA Bozena Sweden 2007OSZTHEIMER István Hungary 2013OUSS Alexandre Netherlands 2012PACHON IGLESIAS Marta Spain 2012PADFIELD Gareth United Kingdom 2013PAISEY John United Kingdom 2008PAOLTTI PERINI Alessandro Italy 2015PAPACHRISTIDIS Alexandros United Kingdom 2014PARAVOLIDAKIS Konstantinos Greece 2008PASCALE Patrizio Switzerland 2009PATWALA Ashish United Kingdom 2010PAULUSSEN Guido Netherlands 2006



PAVACI Herribert Albania 2014PAWLIK Tomasz Poland 2012PENA HERNANDEZ Jose Luis Spain 2008PENTEADO Jose Otavio P. Brazil 2012PEREZ ALVAREZ Luisa Spain 2010PEREZ CASTELLANO Nicasio Spain 2005PEREZ DIEZ Diego Spain 2009PERIK Patrick Netherlands 2010PERMENTIER Lianne Netherlands 2015PERNA Francesco Italy 2014PERROTTA Laura Italy 2012PETERS René Netherlands 2015PETKAR Sanjiv United Kingdom 2008PETRACCI Barbara Italy 2009PETRU Jan Czech Republic 2009PETTIT Stephen United Kingdom 2011PHILBERT / JENSEN Berit Thornvig Denmark 2010PHLIPS Thomas Belgium 2014PINDADO RODRIGUEZ Javier Spain 2009PIQUERAS Eric France 2015PLASEK Jiri Czech Republic 2014PLUTA Slawomir Poland 2010POELSLER Robert Germany 2013POGGI Alessio Italy 2014POLGAR Balazs Hungary 2015PORRO Rosa Spain 2009POS Lambertus Netherlands 2013POSTEMA Pieter Netherlands 2015POZZETTI Daniela Italy 2006PRASAD Rachana United Kingdom 2013PREDOVSKI Milen Bulgaria 2011PRENNER Guenther Austria 2015PRISECARU Raluca Belgium 2014PROIETTI Riccardo Italy 2013PRONK Arjen Netherlands 2010PRUSKI Maciej Poland 2010PRZYBYLSKI Andrzej Poland 2007PSYCHARI Stavroula Greece 2011PUCHOL Alberto Spain 2009PUDULIS Janis Latvia 2014PUETZ Vanessa Germany 2013PUGH Peter United Kingdom 2008PYATT Jason United Kingdom 2011RAHEL Braim M. Netherlands 2011RAMANNA Hemanth The Netherlands 2008RAMAZZINA Carola Switzerland 2015RAMCHURN Hemant Belgium 2011RAO Archana United Kingdom 2007RASSIAS Ioannis Greece 2013REBELLATO Luca Italy 2009

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REGOLI François Switzerland 2015REICHLIN Tobias Switzerland 2015REIF Sebastian Germany 2015RESTLE Christian Germany 2009REVERDIN Stephane Switzerland 2013RIAHI Leila Tunisia 2014RICCIARDI Danilo Belgium 2012RICCIARDI Giuseppe Gilberto Italy 2013RIENSTRA Michiel Netherlands 2013RIVAS GANDARA Nuria Spain 2010ROBERT Jens Switzerland 2012ROBERTSON Alan James United Kingdom 2014ROBLES DE MEDINA Ramon Mariano Netherlands 2011ROCA LUQUE Ivo Spain 2011ROCHA Sérgia Portugal 2013RODE Susanne Germany 2013RODRIGUEZ MANERO Moises Belgium 2012ROHNER Andreas Switzerland 2014RORDORF Roberto Italy 2013ROSA Antonio Switzerland 2011ROSSI Andrea Italy 2011ROSSI Luca Italy 2012ROTEN Laurent Switzerland 2008ROUKAS Kriton-Ioannis Greece 2011ROUX Antoine France 2010RUSSI Ian Switzerland 2015RUSSO Giovanni Italy 2009RUZICKA Petr United Kingdom 2011SAFAK Erdal Germany 2011SALAHSHOURI Pegah United Kingdom 2011SALGADO ARANDA Ricardo Spain 2013SALIM Belgin Romania 2014SALMAS Jozef Germany 2015SANCHEZ GARCIA Manuel Spain 2015SANDIN-FUENTES Maria De Gracia Spain 2013SANTOS Nuno Portugal 2013SANTOS CALLE Francisco José Spain 2013SARRIAS Axel Spain 2013SAURER Georg Austria 2013SCHÄR Beat Andreas Switzerland 2013SCHAUMANN Anselm Germany 2009SCHEFFER Michael G. The Netherlands 2008SCHELLINGS Dirk Netherlands 2015SCHGOER Wilfried Austria 2015SCHLIEPHAKE Florian Switzerland 2015SCHMUTZ Mathieu Thomas André

Hermann GhislainSwitzerland 2013

SCHOENBAUER Robert Austria 2015SCHOLZ Brit Germany 2011SCHOONDERWOERD Bas Netherlands 2008



SCHRAGO Gregoire Switzerland 2010SCHREVE-STEENSMA Ariadne Midori Netherlands 2012SCHUKRO Christoph Austria 2011SCHURMANS Joris Belgium 2013SCHWAGTEN Bruno Belgium 2008SCHWERG Marius Germany 2014SCIARAFFIA Elena Sweden 2011SEDLACEK Kamil Czech Republic 2010SEGRETI Luca Italy 2010SEGURA VILLALOBOS Federico Spain 2011SEIFERT Martin Germany 2013SEILER Jens Switzerland 2011SEMICHON Marc France 2013SENOUF David Switzerland 2009SEOW Swee-Chong Singapore 2007SEPSI Milan Czech Republic 2011SERVATIUS Helge Switzerland 2014SGARITO Giuseppe Italy 2006SHCIPPER Jurjan Netherlands 2015SIELSKI Slawomir Poland 2005SILBERBAUER John United Kingdom 2013SIMEONIDOU Eftihia Greece 2006SJOBLOM Johanna Sweden 2008SKENE Chris United Kingdom 2013SKIADAS Ioannis Greece 2011SKRETTEBERG Per Torger Norway 2013SLOOTWEG Andries Netherlands 2014SLOTTE Fredrik Finland 2014SMEELE Frank Netherlands 2011SMEETS Frans Netherlands 2011SMILDE Tom Netherlands 2011SMITS Jeroen Netherlands 2012SOM Zoltan Hungary 2014SONESSON Linus Sweden 2013SORREL Jeremie France 2015SPIERENBURG Han The Netherlands 2008STARTARI Umberto Italy 2014STATESCU Cristian Romania 2009STEEN Torkel Norway 2007STEFAN Liliana Czech Republic 2010STEFAN NICOLEA Bogdan Romania 2009STEFFEL Jan Switzerland 2012STERLINSKI Marciej Poland 2006STEVENHAGEN Jeroen The Netherlands 2008STOCKBURGER Martin Germany 2011STOECKEL Holger Switzerland 2012STRANDERS Ischa Netherlands 2011STRIKWERDA Sipke The Netherlands 2009STUEHLINGER Markus Austria 2011SUN Qi China 2014

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SUPRYN Rafal Poland 2014SUTER Yves Martin Switzerland 2013SWART Hp The Netherlands 2009SYSKA Pawel Poland 2015SZAMLEWSKI Piotr Sweden 2010SZILAGYI Szabolcs Hungary 2013SZTANISZLAV Áron Hungary 2013TAHAPARY Giovanni The Netherlands 2009TAKENS Lambertus H. Netherlands 2014TAN Vern Hsen Singapore 2015TASIC Jerneja Slovenia 2015TEIJEIRA FERNANDEZ Elvis Spain 2013TER BEKKE Rachel The Netherlands 2010TEUBL Alexander Austria 2009THEIß Söhnke Germany 2013TIBITANZL Jan United Kingdom 2015TIELEMAN Robert Netherlands 2009TIMMERS Liesbeth Belgium 2011TOMASI Luca Italy 2012TOMLINSON D. United Kingdom 2009TORCIVIA Riccardo Italy 2010TORN Marieke The Netherlands 2009TOSSEBRO Morten Shoren Norway 2009TRAN Van Nam Switzerland 2015TRAYKOV Vassil B. Bulgaria 2010TREGUER Frederic France 2009TRINES Serge The Netherlands 2008TROFIN Monica Germany 2015TRUCCO Maria Emilce Spain 2012TSCHOLL Verena Germany 2015TUINENBURG Anton Netherlands 2011TUININGA Ype The Netherlands 2009TUREL Baybars Turkey 2009TURK Ugur Onsel Turkey 2011TUTUIANU Cristina Ioana Romania 2013UCER Ekrem Germany 2011UDO Erik Netherlands 2015URBAN Lubos Slovakia 2009VACCARI Diego Italy 2006VALENTE Bruno Portugal 2015VALK Suzanne Netherlands 2010VALZANIA Cinzia Italy 2007VAMOS Mate Hungary 2014VAN ALEM Anouk Netherlands 2010VAN ASSELDONK Jan Netherlands 2015VAN BEMMEL Marnix Netherlands 2014VAN CASTEREN Lieve Belgium 2010VAN DE POLL Sweder Netherlands 2013VAN DEN AKKER-BERMAN Lily Netherlands 2011VAN DEN BERGH Paulus Netherlands 2013



VAN DEN BOS Ewoutjan The Netherlands 2009VAN DEN BRINK Olivier Wv Netherlands 2013VAN DER GALIEN Albert Netherlands 2012VAN DER HEIJDEN Robert Netherlands 2010VAN DER HEIJDEN Dirk Netherlands 2010VAN DER HEIJDEN Jeroen Netherlands 2011VAN DER KLEY Tim Netherlands 2011VAN DER MEER Peter Netherlands 2013VAN DER VEEN Maurits Netherlands 2012VAN DER WAL Henriette Netherlands 2010VAN DER WEERDT Arno Peter Netherlands 2007VAN DEURSEN Caroline Netherlands 2012VAN DIJK Vincent Netherlands 2013VAN DOORN Dirk Jan Netherlands 2011VAN EMPEL Vanessa Netherlands 2010VAN ES Robert Netherlands 2011VAN GASTEL Henk Christiaan Netherlands 2010VAN GENT Marco Netherlands 2012VAN HAELST Paul Netherlands 2012VAN HERENDAEL Hugo Belgium 2009VAN HEUVERSWIJN Frederic Belgium 2011VAN HORSSEN Elisabeth Veronica Netherlands 2013VAN KRAAIJ Dave The Netherlands 2009VAN MALDEREN Sophie C.H. Belgium 2013VAN NOORD Trudeke Netherlands 2007VAN OFWEGEN-HANEKAMP Clara Emilia Emese Netherlands 2013VAN OOSTROM Antonie Netherlands 2009VAN OPSTAL Jurren Netherlands 2007VAN PETEGHEM Sylvie Belgium 2014VAN POPELE Nicole Netherlands 2013VAN REIJ Frank Netherlands 2010VAN ROOSMALEN Radboud Netherlands 2011VAN SCHAARDENBURGH Pepijn The Netherlands 2009VAN SCHAIKVAN DER WIELEN Marielouise The Netherlands 2009VAN VLIES Bob Netherlands 2010VAN WIJK Leendert M. Netherlands 2013VAN WOERKENS Leon Netherlands 2011VANDER Marianna Russia 2015VANDUYNHOVEN Philippe Belgium 2014VASILOPOULOS Charalambos Greece 2006VATASESCU Radu- Gabriel Romania 2006VELTMANN Christian Germany 2014VENABLES Paul United Kingdom 2010VERBUNT Robert Netherlands 2011VERGARA Pasquale Italy 2009VERNOOY Kevin Netherlands 2010VET Thijs The Netherlands 2008VICENTINI Alessandro Italy 2009VIERGEVER Eric Paul Netherlands 2010VIJN Arie Gerhard Netherlands 2010

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VILLUENDAS SABATE Roger Spain 2010VISMAN Roeland Netherlands 2015VITALE Raffaele Italy 2013VITALI SERDOZ Laura Germany 2015VOLKOV Dmytro Ukraine 2013VON BARY Christian Germany 2011VOSS Frederik Germany 2008VRAZIC Hrvoje Croatia 2011VRIEND Joris Netherlands 2011WALHOUT Ronald Netherlands 2011WALKER Alexander Josef Switzerland 2014WEBERNDÖRFER Christina Vanessa Switzerland 2013WERETKA Slawomir Germany 2011WESTENBRINK B. Daan Netherlands 2015WESTENDORP Iris Netherlands 2006WESTPHALEN Alexander Switzerland 2015WESTRA Sjoerd Netherlands 2009WETZEL Ulrike Renate Germany 2013WHINNETT Zachary United Kingdom 2011WIDDERSHOVEN Josef Jos The Netherlands 2009WIJCHERS Sip Belgium 2009WIJFFELS DE GROOT Sofia Netherlands 2015WIJNMAALEN Adrianus Netherlands 2015WILLEMS Albert Richard Netherlands 2009WINTER Siegmund Austria 2010WITT Christoffer Tobias Denmark 2015WO Hung-Ta Taiwan 2015WOLF Michael Belgium 2014WOLLMANN Christian Austria 2011WONG Ka Lam China 2013YAP Sing-Chien Netherlands 2012YEO Wee Tiong Singapore 2013YUNG Arthur China 2015ZACA‘ Valerio Italy 2015ZAGKLI Fani Greece 2013ZAJAC Dariusz Poland 2012ZAKY Hosam United Arab Emirates 2007ZALEVSKY Valery P. Ukraine 2007ZELJKO Hrvojka Marija Croatia 2013ZEMAN Kamil Czech Republic 2013ZERVOPOULOS George Greece 2006ZIMA Endre Hungary 2009ZIZEK David Slovenia 2015ZOPPO Franco Italy 2006ZUCCHELLI Giulio Italy 2008ZYCINSKI Pawel Poland 2014


Allied ProfessionalsCertified Allied Professionals

AMAZINE Natja Netherlands 2015AMIRANDA Giuseppe Italy 2015ANSELMI Vittorio Italy 2015ANTENBRINK Johannes Fredericus Netherlands 2011ARNDELL Dianne Netherlands 2015ARTS Germaine Netherlands 2011ARUMUGAM Paul Ayyappan United Kingdom 2014BAKKER Emiel Netherlands 2015BATSIKAS Kimon Greece 2013BENEDUCE Roberta Italy 2015BERGERVOET Jan Netherlands 2015BERNARDES Ana Portugal 2015BERTOLI Fabrizio Switzerland 2013BESTEN DEN Truus Netherlands 2013BETTEN Jort Netherlands 2015BIJL Jeroen Netherlands 2015BIJVOET Eleonora Netherlands 2011BOWEN Daniel United Kingdom 2015BRAAM Nort Netherlands 2014BRANTS Ruud Netherlands 2014BROENINK Ingrid Netherlands 2014BRUEGGEMANN Thomas Germany 2013BURGOS Jesús Spain 2013BURKHARDT Dr.Dietmar Germany 2015BUSKES Marjo Netherlands 2014CARCONI Marco Italy 2015CARRERO David Spain 2014CHAITSING Rismy Netherlands 2015DE BLAAUW Mariska Netherlands 2014DE CLERCQ Katrien Belgium 2014DE GRAAF Hendrik Netherlands 2014DE KEYZER-VAN MUIJLWIJK Klara Netherlands 2012DE KONING Rens Netherlands 2015DE LA VIEJA ALARCON Juan José Spain 2015DE MELKER Robert Netherlands 2012DE ROVER Vincent Netherlands 2013DE RUITER Wouter Arie Netherlands 2015DE VRIES - VAN DER MOLEN Carla Netherlands 2014DE WINTER Peter Netherlands 2014DEBIE Luuk Netherlands 2013DELLEA Alessandro Italy 2015DEMOZZI Marilena Italy 2015DEUNK Gerhard Netherlands 2015DIJKERS-SICCAMA Maria Martina Netherlands 2015EBES F.J. Netherlands 2015EDENS Joran Netherlands 2011ENGELAER Paulus Johannes Maria Germany 2013FABRIZI Agnese Italy 2015FERSINI Gabriele Italy 2015FOCARDI Alessandro Italy 2015FOGH JONNASSON Pernille Denmark 2014GERCAMA Ale Netherlands 2012

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Certified Allied Professionals

GEURS Paul Netherlands 2015GIACOPELLI Daniele Italy 2015GOMEZ LLAUGER Albert Spain 2015GOPINATH Binoob United Kingdom 2013GOUGH Jacqueline Netherlands 2012GRASDIJK Michel Netherlands 2013GRASSINI Diego Italy 2015GRAUENKAMP Caspar Netherlands 2012GRESSONI Sara Italy 2015GRIFFITHS Jon United Kingdom 2014GRIMBERG Arenda Netherlands 2013GROEN Henk Netherlands 2014GROVE Ulrik Denmark 2014HAAS DE Oudshoorn Netherlands 2013HAMOEN Marinus Netherlands 2014HAUGDAL Martin Aar Denmark 2013HENDRIKS Thijs Netherlands 2013HOFSTEDE Jan Netherlands 2013HOJGAARD Susanne Denmark 2014HOP Henri Marco Netherlands 2011HULSKOTTE J.H.N. Netherlands 2015HUSKENS Paul Netherlands 2013IGLESIAS BRAVO Jose Antonio Spain 2014JANSSEN Michel Netherlands 2013JOSEPH Marielle Netherlands 2014KAMMEIJER Willem Netherlands 2013KEIJZER Rens Netherlands 2012KEUKEN Johannes Netherlands 2014KINCH WESTERDAHL Annika Sweden 2013KNOPS Paul Netherlands 2013KOFLER Ruth Austria 2012KUUR VAN DER Erwin Ronald Netherlands 2014LA GRAND Reinalda Netherlands 2011LAST Tim Netherlands 2012LAU Tsan Fung China 2014LAURETTI Maurelio Domenico Italy 2015LEGGIERO Angelo Italy 2015LEWIS Peter United Kingdom 2015LINSSEN-ABEN Maria Helena Hendrica Netherlands 2011LO GIUDICE Vincenzo Italy 2015LUIJTEN Kees Netherlands 2014MAARSE Albert Netherlands 2013MAAT-POOT Barbara Maria Netherlands 2014MARCHANT Isabelle Netherlands 2014MAWHOOD Sue United Kingdom 2014MEIJER Kim Netherlands 2014MEIJER Karin Maria Netherlands 2013MIEDEMA Pieter Netherlands 2014MINTJENS Martin Netherlands 2015MOL Daniel Netherlands 2013MOORE Chris United Kingdom 2015MORINI Filippo Italy 2015



MUNOZ Julio Spain 2011NASTA Gianluca Italy 2015NATHOE Mohamed Djabbaar Netherlands 2014NEVE Eric Netherlands 2014NIJKAMP Dennis Netherlands 2015OLIVEIRA Joao Rodrigo Portugal 2014OOSTERWEGHEL Jeannette Netherlands 2012OSKAM Aart Netherlands 2013OVEREEM Bartjan Netherlands 2012PAIANO Salvatore Italy 2015PALETTA Alessandro Italy 2015PALUMBO Annalisa Italy 2015PASMAN Harrold Netherlands 2014PASTORE Cosimo Netherlands 2013PATTERSON-ROTTGERING Wendy Netherlands 2012PEARSON Theodore United Kingdom 2015PEREIRA Helder United Kingdom 2012PILAGE Robert Netherlands 2014PIMENTA Ricardo Portugal 2012PISCEDDA Valerio Belgium 2011PISCITELLI Gioacchino Italy 2015PRATAS DA SILVA Francisco Emanuel United Kingdom 2014PURCHASE Nicole United Kingdom 2014QVARNSTRÖM Eva Sweden 2013RAMSOEKH Wandana Netherlands 2015RAVERS Henry Netherlands 2013REK Anita Netherlands 2014REKKER Kees Netherlands 2013RESCIGNO Stefania Italy 2015RICH Caroline United Kingdom 2014RIERA Marta Spain 2015RIETRAE Rachel Netherlands 2015RIJSWIJK Nathalia Hillegonda Netherlands 2014RITZEN John Netherlands 2014RODRIGUES DA SILVA ANDRADE Jose Tomas United Kingdom 2014RUSSELL Mark Irland 2015RUSSO Gerardo Italy 2015SANCHEZ HUETE Gonzalo Spain 2015SANTOS CALLE Francisco José Spain 2013SCHAIBLE Bernd Germany 2015SCHERER Brenda Netherlands 2014SCHROEMGES Johannes Netherlands 2014SCHUMM Steven Netherlands 2012SCHUURMAN Bert Netherlands 2013SCHUURMAN-VAN DER ZWAAN Marielle Netherlands 2014SEFFINGA Kees Netherlands 2012SIEBERT Sijmon Netherlands 2015SILVA Ines United Kingdom 2015SLIJKERMAN Myrna Netherlands 2012SMITS Xavier Netherlands 2015SMITS-GELISSEN Marloes Netherlands 2015SOARES Filipe Germany 2011

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SOESBERGEN Joop Netherlands 2013SOUGIANNIS Dimitrios Greece 2012SPRINGORUM Bob Netherlands 2014STEIJAERT Patrick Netherlands 2014STEL Erik Netherlands 2013STOFFELS Kim Netherlands 2015STOLL Eric Netherlands 2012STORM Margaretha Netherlands 2013STUART Jonas Denmark 2014SULLIVAN Siobháin United Kingdom 2015SVENSSON Emma Sweden 2011TER AVEST- ROELINK Leonie Netherlands 2013TERBURG Bonnie Netherlands 2014THERON Adam United Kingdom 2015THIJSSEN Robert Vincent Matthias Netherlands 2014TIDDENS Ronaldus Netherlands 2015TRIYASUT Grisana Netherlands 2013UGEN Ad Netherlands 2011UITERWAAL Hans Netherlands 2011VAN CRUIJSEN Marc Netherlands 2013VAN DER DRIFT Mireille Netherlands 2011VAN DER KEMP Peter Netherlands 2011VAN DER NAGEL Roel Netherlands 2015VAN DER SALM K. Netherlands 2014VAN DER SMAN Yoeri Walter Netherlands 2011VAN DIJK Frederik Netherlands 2013VAN DOORN Arjan Netherlands 2011VAN ELS - RUTTEN Anna Netherlands 2012VAN ELSACKER Andreas Netherlands 2015VAN GOOL Stephan Netherlands 2015VAN KOOTEN Andre Netherlands 2014VAN OORT Geeske Netherlands 2013VAN VELDHUIZEN Erny Netherlands 2013VASCONCELOS Hugo Morujo Portugal 2013VENANCIO GALVAO Julia Maria Netherlands 2012VERSTEEG Astrid Netherlands 2014VILLADEAMIGO Juan Manuel Spain 2012VISSCHER-HARINK Sabine Netherlands 2015VOS Jeroen Netherlands 2015WALRAVEN Jacintha Netherlands 2015WALSH Andrea Irland 2015WASSEN Jeroen Netherlands 2014WHITAKER Lynne United Kingdom 2014WILS Alexandra Netherlands 2013WOLTING Roelof John Netherlands 2012XAVIER Ana Portugal 2012ZANELLA Michela Italy 2015ZERIKIOTIS Evangelos Greece 2013ZUMBRINK Jacobus Johannes Maria Netherlands 2013

Documents

The Current Status of Cardiac Electrophysiology in ESC ......The EHRA White Book 2016 . 1 Prof. Béla Merkely EHRA National Cardiac Society Committee Chair (2015–2017) Prof. Pekka