EHRA Highlight on Switzerland

1. Presentation of the EP NCS/WG

• Link to Working Group: http://www.pacemaker.ch/
• Link to National Cardiac Society: http://www.swisscardio.ch/
• Link to the Swiss Annual Rhythm Congress: http://swissrhythm.org/

Is there a specific National Cardiac Society for cardiac rhythm disorders or is it a Working Group?

• It is a Working Group within the National Cardiac Society

Our goals are:

• to promote quality of care
• to apply science for the benefit of our population
• to promote research  and education promote collaboration between members of our group

A Committee of 10 members, composed in the following way:

• 1 representative from each of the 5 university hospitals
• 1 representative of regional hospitals from each of the 3 linguistic regions (French, German and Italian)
• 1 representative of the private sector
• 1 representative of the paramedical sector

A president is elected for a 2-year term (rotational basis).

Professor Haran Burri, is the current President (2015-2017)

What (if any) regulatory role does it have?

Publication of recommendations for EP/CP procedures

Is there a national exam organised by the society?

No, the EHRA exam is sat by members wishing to declare competencies in EP/CP

Are there any specific educational/academic activities organised by the society?

• An annual congress (http://swissrhythm.org/). This involves a 2-day meeting on arrhythmias, device therapy and electrophysiology
• An annual CME course on device troubleshooting (1-day, directly preceding Swissrhythm)
• Organisation of sessions on arrhythmias/CP/EP during the Annual Scientific Sessions of the Swiss Society of Cardiology

Are there specific roles attached to the committee members' positions?

• President, President-Elect, Treasurer
• In addition, each committee member has a specific task (e.g. congress organisation, reimbursement issues, patient education etc)

Does the National Cardiac Society have any specific role in research?

Research and educational grants are given by the Swiss Heart Foundation, the Foundation of the Working Group of Pacing and Electrophysiology and the Swiss National Fund for Research

 2. Heart Rhythm Centres

What are the legal requirements for a hospital to implant devices or perform ablations?

There is unfortunately very little legal framework.

Are there any national guidelines for heart rhythm centres?

Our Working Group has been publishing recommendations since 2000, updated in 2005, 2011 and 2015

The minimum number of cases performed?

Recommendations on minimum annual caseload for physicians as well as for centres are published in our recommendations 

The minimum number of specialists?

These are defined in our recommendations

How are cardiac rhythm services funded? Are there any unusual reimbursement arrangements?

Public funding (university and regional hospitals) and also by patient-contracted insurances

How are procedure outcomes reported? Is there a national database?

All device implantations and ablations must be captured on a national online secured database (CHPACEWEB)

3. Heart Rhythm Specialists

Physicians

Are there separate ‘device’ or ‘ablation’ specialists?

There is no official title

What is the duration of training?

As per EHRA recommendations (at least 1 year in EP and/or CP)

Can it be combined with training for a cardiologist?

Yes

What is the required number of procedures?

As per current EHRA certification recommendations

Are specific exams (e.g. EHRA) obliged?

Yes, EP and/or CP

What criteria have to be met to stay an electrophysiologist?

Our recommendations specify the annual caseload required to maintain competency in EP/CP

Allied Professionals

What are the different types and roles of Allied Professionals in cardiac rhythm management (physiologists, nurse specialists)?

Their background is variable (technicians, nurses etc). The personnel usually perform device follow-up under the supervision of a cardiologist. In the EP lab, they participate in setting up the procedure and handling the EP bay.

Is there a specific governing body for allied professionals?

Yes, a working group

Is there a national education program?

The EHRA curriculum is followed

Is any exam or accreditation mandatory or advised e.g. the EHRA exam?

Yes, the ERHA exam in CP and EP (Switzerland was the first to introduce this exam in its recommendations in 2011)

Please tell us anything else you would like to highlight about your national society or cardiac rhythm management in your country

Switzerland has a diversity of languages (German, French, Italian) and mentalities in the different regions. Despite these challenges, collaboration is good and we strive towards common goals.
A challenge is to maintain quality by avoiding multiplication of low-volume centres

Learn more about the Swiss Pacing and Electrophysiology Working Group here.