The Cardiothoracic Centre Liverpool NHS Trust (Figure 1) is a large tertiary referral center in the north-west of England, and among the leading specialist heart and chest hospitals in the United Kingdom, with the largest pacemaker implantation unit in the country. It serves a population of over 2.8 million over a catchment area comprising metropolitan Liverpool, Merseyside, Lancashire, Cheshire, North Wales and the Isle of Man.

In terms of the volume of procedures, the Cardiothoracic Centre is probably the third largest center in the UK, and in terms of pacing procedures it is number one in the UK and among the top two or three in Europe. The hospital also has a leading position in radial coronary procedures, which virtually eliminate access site complications, and are characterized by a faster partient throughput and a shorter recovery time.

The Cardiothoracic Centre has nine operating rooms and four cath labs. A Philips Allura flatpanel system is currently being installed. A team of five consultant cardiologists perform about 1200 implants a year, including a large volume of biventricular work.

In 2004 about 100 biventricular devices were implanted, out of a total of around 1000 in the U.K. The proportion of biventricular implants is steadily increasing.

As the BV Pulsera has been in use for six months, it will have been used for about 600 procedures. Of these, some 75 will be biventricular pacing, 80 will be ICD's, and about 20 will be extractions, some of which will have used laser equipement.

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