PT - JOURNAL ARTICLE AU - Amar Mistry AU - Zakariyya Vali AU - Bharat Sidhu AU - Charley Budgeon AU - Matthew F Yuyun AU - Vivetha Pooranachandran AU - Xin Li AU - Michelle Newton AU - Jamie Watts AU - Kamlesh Khunti AU - Nilesh J Samani AU - G Andre Ng TI - Disparity in implantable cardioverter defibrillator therapy among minority South Asians in the United Kingdom AID - 10.1136/heartjnl-2019-315978 DP - 2020 May 01 TA - Heart PG - 671--676 VI - 106 IP - 9 4099 - http://heart.bmj.com/content/106/9/671.short 4100 - http://heart.bmj.com/content/106/9/671.full SO - Heart2020 May 01; 106 AB - Objective There are large geographical differences in implantable cardioverter defibrillator (ICD) implantation rates for reasons not completely understood. In an increasingly multiethnic population, we sought out to investigate whether ethnicity influenced ICD implantation rates.Methods This was a retrospective, cohort study of new ICD implantation or upgrade to ICD from January 2006 to February 2019 in recipients of Caucasian or South Asian ethnicity at a single tertiary centre in the UK. Data were obtained from a routinely collected local registry. Crude rates of ICD implantation were calculated for the population of Leicestershire county and were age-standardised to the UK population using the UK National Census of 2011.Results The Leicestershire population was 980 328 at the time of the Census, of which 761 403 (77.7%) were Caucasian and 155 500 (15.9%) were South Asian. Overall, 2650 ICD implantations were performed in Caucasian (91.9%) and South Asian (8.1%) patients. South Asians were less likely than Caucasians to receive an ICD (risk ratio (RR) 0.43, 95% CI 0.37 to 0.49, p<0.001) even when standardised for age (RR 0.75, 95% CI 0.74 to 0.75, p<0.001). This remained the case for primary prevention indication (age-standardised RR 0.91, 95% CI 0.90 to 0.91, p<0.001), while differences in secondary prevention ICD implants were even greater (age-standardised RR 0.49, 95% CI 0.48 to 0.50, p<0.001).Conclusion Despite a universal and free healthcare system, ICD implantation rates were significantly lower in the South Asian than the Caucasian population residing in the UK. Whether this is due to cultural acceptance or an unbalanced consideration is unclear.