devices key facts Based on the Heart Rhythm Foundation Workforce Study, here are the pacemaker and ICD implantation rates (Initial and Replacement) in the United States: Year Population Total Pacemaker Implants Per Million Total ICD Implants Per Million 1992 255,078,000 135,000 529 12,300 48 1993 257,908,000 141,000 547 14,500 56 1994 260,921,000 149,000 571 17,250 66 1995 263,434,000 159,000 604 21,000 80 Source: From unpublished industrial sources. Replacements represent about 20% of pacemakers and 30% of ICDs. Several studies have shown lower use of cardiac procedures in racial/ethnic minorities. One particular study found that, in a large population of California patients hospitalized for life-threatening ventricular arrhythmia (LTVA), blacks received significantly fewer invasive electrophysiological studies (EPS) and ICD procedures than whites and had higher mortality rates a year later. 1 Many studies show that ICDs are effective to reduce mortality. They are most effective for patients who have experienced ventricular fibrillation or tacycardia. In another study, ICD patients who receive an ICD initially pay more because of the cost of the device but pay less in follow-up care than patients treated with medication.2 1AHRQ Research Activities, December 2002: Researchers examine the risk factors for sudden cardiac arrest and management of at-risk patients. Alexander, M., Baker, L., Clark, C., and others (2002). "Management of ventricular arrhythmias in diverse populations in California." American Heart Journal 144, pp. 431-439. 2AHRQ Clinical Highlights: Treatment to Prevent Sudden Cardiac Arrest.