OBJECTIVES: Cardiac implantable electronic devices (CIED) implantation procedures, available in the Brazilian Public Health System (SUS) for more than 30 years, are performed only in tertiary care centers. This research aims to explore CIED implantation centers' landscape in the Brazilian Public Healthcare System.

METHODS: Open data of approved hospital admissions from 2008 to 2019 with CIED implantation (permanent pacemaker, implantable cardioverter-defibrillator [ICD], and cardiac resynchronization therapy [CRT]) reimbursed by SUS were obtained from the Hospital Information System through the Informatic Department of SUS (DATASUS). Individual admissions registers were used to identify and analyze the centers' geographic distribution, characteristics, and activity related to CIED implantation.

RESULTS: In the period, SUS reimbursed 216,440 CIED implantations performed in 260 centers, 40.4% located in capital cities and most being classified as philanthropic institutions (60.8%). The number of centers conducting CIED implants varied yearly, increasing from 190 in 2008 to 226 in 2019 (+18.9%), with a mean of 213 centers. Geographically, most centers were in the Southeast region (n=151, 44.2%), with the states of São Paulo (n=52, 20%) and Minas Gerais (n=35, 13.5%) leading. All centers performed pacemaker implants; 151 (58.1%) implanted pacemakers exclusively, while 87 (33.5%) implanted ICD, 90 (34.6%) CRT, and 80 (30.8%) CRT with defibrillator. The mean (range) total and annual number of implants performed by center in the 12-year period was 832.5 (1; 6,183) and 75.1 (1; 662), respectively. North centers presented the lower mean total (671.4, range 15; 1876) and annual (37.9, range 1; 203) number of implants.

CONCLUSIONS: Real World Evidence from the Brazilian Public Healthcare System indicates that CIED implantation centers have a heterogeneous geographic distribution. An increase in the number of active centers per year was identified. Also, there is considerable variability in the number of procedures and types of device implants performed by each institution.