Inequity of use of implantable cardioverter defibrillators in England: retrospective analysis

Sudden cardiac death occurs in approximately 100 000 people annually in the United Kingdom and can be prevented by implantable cardioverter defibrillators (ICDs).1 Rates of implantation of ICDs in England have been increasing but lag behind those in other western European countries and North America. The National Institute for Clinical Excellence has recommended indications for use in patients with ventricular arrhythmias and proposed an annual implantation rate of 50 per million population.2 We present data on current use, geographical and social equity, and barriers to care in the provision of ICDs in England.