The scope of this report covers critical device-based arrhythmia diagnostic and therapeutic systems that are routinely employed in the management of patients with such conditions as debilitating bradycardia and heart block, life-threatening atrial and ventricular tachyarrhythmias, cardiac asynchrony associated with progressing heart failure, arrhythmia-induced cardiogenic shock and sudden cardiac arrest.
The U.S. Cardiac Rhythm Management Products Market totaled more than $7.9 billion in 2009 and despite prevailing economic conditions is expected to grow at a healthy 4.8% compound annual rate, reaching more than $10.0 billion in 2014.
This dynamic report from Medtech Insight includes analyses of products, markets, competitors, and emerging technology and opportunities. Product areas include: electrocardiography systems, diagnostic electrophysiology transcatheter systems, cardiac pacemakers, implantable cardioverter defibrillator systems, cardiac resynchronization therapy systems, automated external defibrillator systems, transcatheter arrhythmia ablation systems, and directed-energy based surgical ablation systems.
EXECUTIVE SUMMARY i. Heart Anatomy and Physiology ii. Cardiovascular Disease a. Arrhythmia b. Types of Arrythmia c. Supraventricular Arrythmia/Tachycardia d. Atrial Fibrillation e. Atrial Flutter f. Paroxysmal Supraventricular Tachycardia g. Ventricular Arrhythmia h. Bradycardia iii. Treatment a. Medication b. Cardiac Resynchronization Devices, Implantable Cardioverter Defibrillators, and Pacemakers c. Cardiac Surgery d. Catheter Ablation e. Vagal Maneuvers iv. Combined Market Analysis v. Methodology Exhibit ES-1: Incidence and Prevalence of Common Cardiac Arrhythmias and Associated Disorders, 2009 and 2014 Exhibit ES-2: Diagram of the Heart Exhibit ES-3: Cardiac Rhythm Management Procedures, Combined Procedure Volumes Forecast, 2008-2014 Exhibit ES-4: Cardiac Rhythm Management Products, Combined Market Forecast, 2008-2014 Exhibit ES-5: Cardiac Rhythm Management Products, Combined Market Forecast, by Segment, 2008-2014 Exhibit ES-6: 2009, Cardiac Rhythm Management Products Market, Share by Segment Exhibit ES-7: 2014, Cardiac Rhythm Management Products Market, Share by Segment 1. CARDIAC RHYTHM DISORDERS OVERVIEW 1.1 Heart Anatomy and Physiology 1.1.1 The Rhythmic Beating of the Heart 1.1.2 The Blood Circulatory System 1.1.3 The Cardiac Conduction System 1.2 Cardiovascular Disease 1.3 Arrhythmia 1.3.1 Types of Arrythmia 188.8.131.52 Supraventricular Arrythmia/Tachycardia 184.108.40.206.1 Atrial Fibrillation 220.127.116.11.2 Atrial Flutter 18.104.22.168.3 Paroxysmal Supraventricular Tachycardia 22.214.171.124 Ventricular Arrhythmia 126.96.36.199 Bradycardia 1.3.2 Symptoms 1.3.3 Causes and Risk Factors 1.3.4 Diagnosis 1.3.5 Treatment 188.8.131.52 Medication 184.108.40.206 Cardiac Resynchronization Devices, Implantable Cardioverter Defibrillators, and Pacemakers 220.127.116.11 Cardiac Surgery 18.104.22.168 Catheter Ablation 22.214.171.124 Vagal Maneuvers Exhibit 1-1: Incidence and Prevalence of Common Cardiac Arrhythmias and Associated Disorders, 2009 and 2014 Exhibit 1-2: Diagram of the Heart 2. CARDIAC RHYTHM DISORDERS DIAGNOSIS AND MANAGEMENT 2.1 Clinical Diagnosis of Cardiac Rhythm Disorders 2.1.1 Electrocardiography 126.96.36.199 Resting Electrocardiography 188.8.131.52 Exercise/Stress Testing 184.108.40.206 Holter Monitoring 220.127.116.11 Transtelephonic Event Recording 18.104.22.168 Signal-Averaged Electrocardiography 2.1.2 Tilt-Table Testing 2.1.3 Electrophysiology Studies 22.214.171.124 Conventional Electrophysiology Studies 126.96.36.199 Advanced Electrophysiology Mapping/Navigation 2.2 Therapeutic Management of Cardiac Rhythm Disorders 2.2.1 Antiarrhythmic Pharmacotherapy 2.2.2 Implantable Device-Based Arrhythmia Therapy 188.8.131.52 Cardiac Pacemakers 184.108.40.206.1 Pacemaker Types and Coding 220.127.116.11.1.1 Fixed-Rate and Demand 18.104.22.168.1.2 Single-Chamber and Dual-Chamber 22.214.171.124.1.3 Rate-Responsive Pacing 126.96.36.199.1.4 Magnetic Resonance Imaging-Compatible 188.8.131.52.1.5 Leads and Electrodes 184.108.40.206.2 Indications for Implantation 220.127.116.11.3 Selection and Programming 18.104.22.168.4 Temporary Pacing Systems 22.214.171.124 Implantable Cardioverter Defibrillators 126.96.36.199.1 Technology and Implantation 188.8.131.52.2 Clinical Data 184.108.40.206.3 Selection and Programming 220.127.116.11 Cardiac Resynchronization Therapy 18.104.22.168.1 Technology and Implantation 22.214.171.124.2 Clinical Data 126.96.36.199.3 Indications and Contraindications 188.8.131.52.4 Emerging Applications and Current Clinical Trials 184.108.40.206.4.1 Boston Scientific 220.127.116.11.4.2 Medtronic 18.104.22.168.4.3 St. Jude Medical 2.2.3 Automated External Defibrillation 22.214.171.124 Technology 126.96.36.199 End-Users 2.2.4 Arrhythmia Ablation 188.8.131.52 Transcatheter Ablation 184.108.40.206.1 Percutaneous Transcatheter Ablation of Atrial Fibrillation 220.127.116.11 Directed Energy-Based Surgical Ablation of Atrial Fibrillation Exhibit 2-1: Normal Electrocardiogram Trace Exhibit 2-2: Selected Major Cardiac Rhythm Disorders and Current Treatment Protocols Exhibit 2-3: Vaughan-Williams Classification of Antiarrhythmic Drugs, by Action Mechanism Exhibit 2-4: NBG Codes for Implantable Cardiac Pacemakers Exhibit 2-5: Comparison of Rate-Adaptive Pacing Modalities Exhibit 2-6: Selected Rate-Adaptive Pacing Modalities for the Management of Atrial and Endless Loop Tachycardias Exhibit 2-7: NBD Codes for Implantable Cardioverter Defibrillators Exhibit 2-8: Selected Implantable Cardioverter Defibrillator Features and Labeling Exhibit 2-9: Selected Major Cardiac Resynchronization Therapy Clinical Trials Exhibit 2-10: Indications and Contraindications for Cardiac Resynchronization Therapy Devices Exhibit 2-11: Expanded Recommendations for Cardiac Resynchronization Therapy in Patients with Heart Failure 3. CARDIAC RHYTHM MANAGEMENT DEVICES MARKET 3.1 Cardiac Rhythm Diagnostic Systems Market 3.1.1 Electrocardiogram Systems 18.104.22.168 Selected Products 22.214.171.124.1 Cardiac Science 126.96.36.199.2 GE Healthcare/General Electric 188.8.131.52.3 Philips Healthcare/Royal Philips Electronics 184.108.40.206 Procedure Volumes 220.127.116.11 Market Analysis 18.104.22.168 Competitive Analysis 3.1.2 Diagnostic Electrophysiology Catheters 22.214.171.124 Selected Products 126.96.36.199.1 Bard Electrophysiology/C.R. Bard 188.8.131.52.2 Biosense Webster/Johnson & Johnson 184.108.40.206.3 Boston Scientific 220.127.116.11.4 St. Jude Medical 18.104.22.168 Procedure Volumes 22.214.171.124 Market Analysis 126.96.36.199 Competitive Analysis 3.2 Cardiac Rhythm Therapy Systems Market 3.2.1 Cardiac Pacemakers 188.8.131.52 Selected Products 184.108.40.206.1 Boston Scientific 220.127.116.11.2 Medtronic 18.104.22.168.3 St. Jude Medical 22.214.171.124 Procedure Volumes 126.96.36.199 Market Analysis 188.8.131.52 Competitive Analysis 3.2.2 Implantable Cardioverter Defibrillator Systems 184.108.40.206 Selected Products 220.127.116.11.1 Boston Scientific 18.104.22.168.2 Medtronic 22.214.171.124.3 St. Jude Medical 126.96.36.199 Procedure Volumes 188.8.131.52 Market Analysis 184.108.40.206 Competitive Analysis 3.2.3 Cardiac Resynchronization Therapy Systems 220.127.116.11 Selected Products 18.104.22.168.1 Boston Scientific 22.214.171.124.2 Medtronic 126.96.36.199.3 St. Jude Medical 188.8.131.52 Procedure Volumes 184.108.40.206 Market Analysis 220.127.116.11 Competitive Analysis 3.2.4 Automated External Defibrillator Systems 18.104.22.168 Selected Products 22.214.171.124.1 Cardiac Science 126.96.36.199.2 Physio-Control/Medtronic 188.8.131.52.3 Philips Healthcare/Royal Philips Electronics 184.108.40.206.4 ZOLL Medical 220.127.116.11 Procedure Volumes 18.104.22.168 Market Analysis 22.214.171.124 Competitive Analysis 3.2.5 Arrhythmia Ablation Products 126.96.36.199 Catheter Ablation Systems 188.8.131.52.1 Selected Products 184.108.40.206.1.1 Biosense Webster/Johnson & Johnson 220.127.116.11.1.2 Boston Scientific 18.104.22.168.1.3 Medtronic 22.214.171.124.2 Procedure Volumes 126.96.36.199.3 Market Analysis 188.8.131.52.4 Competitive Analysis 184.108.40.206 Directed Energy-Based Surgical Ablation Systems 220.127.116.11.1 Selected Products 18.104.22.168.1.1 AtriCure 22.214.171.124.1.2 ATS Medical/Medtronic 126.96.36.199.1.3 Medtronic 188.8.131.52.2 Procedure Volumes 184.108.40.206.3 Market Analysis 220.127.116.11.4 Competitive Analysis 3.3 Combined Market Analysis Exhibit 3-1: Diagnostic Electrocardiogram and Transcatheter Electrophysiology Examinations, Procedure Volumes Forecast, 2008-2014 Exhibit 3-2: Diagnostic Electrocardiogram and Transcatheter Electrophysiology Systems, Combined Market Forecast, 2008-2014 Exhibit 3-3: Cardiac Science's Burdick Atria 3100 and Atria 6100 Electrocardiogram Systems Exhibit 3-4: Cardiac Science's Burdick Universal Electrocardiogram System Exhibit 3-5: Cardiac Science's Quinton Q-Stress Cardiac Stress Testing System Exhibit 3-6: Cardiac Science's Burdick HeartStride Cardiac Stress Testing System Exhibit 3-7: GE Healthcare's MAC Resting Electrocardiogram System Exhibit 3-8: Philips Healthcare's PageWriter TC50 and TC70 Cardiographs Exhibit 3-9: Philips Healthcare's PageWriter Trim Line of Cardiographs Exhibit 3-10: Electrocardiogram Examinations, Procedure Volumes Forecast, 2008-2014 Exhibit 3-11: Electrocardiogram Systems, Market Forecast, 2008-2014 Exhibit 3-12: 2009, Electrocardiogram Systems Market, Share by Supplier Exhibit 3-13: Bard Electrophysiology's Orbiter PV Variable Loop Mapping Catheter Exhibit 3-14: Bard Electrophysiology's Conforma Bi-Directional Diagnostic Catheter Exhibit 3-15: Bard Electrophysiology's 20-Pole Fixed Curve Specialty Catheter Exhibit 3-16: Bard Electrophysiology's CS Assist Specialty Catheter Exhibit 3-17: Biosense Webster's LASSO Circular Mapping Catheter Exhibit 3-18: Biosense Webster's PentaRay High-Density Mapping Catheter Exhibit 3-19: Biosense Webster's HALO XP Twenty Electrode Catheter Exhibit 3-20: Boston Scientific's Constellation Full Contact Mapping Catheter Exhibit 3-21: Boston Scientific's AFocus Steerable Diagnostic Catheter Exhibit 3-22: Boston Scientific's Blazer Dx-20 Bidirectional Duodecapolar Diagnostic Catheter Exhibit 3-23: Boston Scientific's Polaris Dx Steerable Diagnostic Catheter Exhibit 3-24: Boston Scientific's Inquiry HIS Diagnostic Catheter Exhibit 3-25: St. Jude Medical's Reflexion HD Mapping Catheter Exhibit 3-26: St. Jude Medical's Reflexion Spiral Variable Radius Catheter Exhibit 3-27: St. Jude Medical's Inquiry Optima PLUS Diagnostic Catheter Exhibit 3-28: Diagnostic Electrophysiology Catheter Studies, Procedure Volumes Forecast, 2008-2014 Exhibit 3-29: Diagnostic Electrophysiology Catheters, Market Forecast, 2008-2014 Exhibit 3-30: 2009, Diagnostic Electrophysiology Catheters Market, Share by Supplier Exhibit 3-31: Cardiac Rhythm Therapy, Procedure Volumes Forecast, 2008-2014 Exhibit 3-32: Cardiac Rhythm Therapy Products, Market Forecast, 2008-2014 Exhibit 3-33: Implantable Pulse Generator Implantation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-34: Implantable Pulse Generators, Market Forecast, 2008-2014 Exhibit 3-35: Boston Scientific's ALTRUA Line of Pacemakers Exhibit 3-36: Medtronic's Adapta and EnRhythm Pacemakers, and CareLink Remote Monitoring Network Exhibit 3-37: Medtronic's Revo MRI SureScan Pacemaker Exhibit 3-38: St. Jude Medical's ACCENT RF Pacemaker Exhibit 3-39: St. Jude Medical's ACCENT MRI Pacemaker Exhibit 3-40: St. Jude Medical's AFFINITY DR Pacemaker Exhibit 3-41: St. Jude Medical's IDENTITY ADx DR Pacemaker Exhibit 3-42: Cardiac Pacemaker Implantation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-43: Cardiac Pacemaker Systems, Market Forecast, 2008-2014 Exhibit 3-44: 2009, Cardiac Pacemaker Systems Market, Share by Supplier Exhibit 3-45: Boston Scientific's CONFIENT, TELIGEN, and VITALITY Implantable Cardioverter Defibrillators Exhibit 3-46: Medtronic's Maximo II and Secura Implantable Cardioverter Defibrillators Exhibit 3-47: St. Jude Medical's Fortify Implantable Cardioverter Defibrillator and Unify Cardiac Resynchronization Therapy Defibrillator Exhibit 3-48: Implantable Cardioverter Defibrillator Implantation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-49: Implantable Cardioverter Defibrillators, Market Forecast, 2008-2014 Exhibit 3-50: 2009, Implantable Cardioverter Defibrillators Market, Share by Supplier Exhibit 3-51: Boston Scientific's COGNIS Cardiac Resynchronization Therapy Defibrillator Exhibit 3-52: Selected Screenshot of Boston Scientific's CONTAK RENEWAL 3 RF Software Exhibit 3-53: Boston Scientific's CONTAK RENEWAL TR's Independent Channels Feature Exhibit 3-54: Medtronic's Maximo Cardiac Resynchronization Therapy Defibrillator Exhibit 3-55: St. Jude Medical's Anthem, Atlas+, Frontier II, and Promote Plus Cardiac Resynchronization Therapy Devices Exhibit 3-56: Cardiac Resynchronization Therapy Device Implantation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-57: Cardiac Resynchronization Therapy Devices, Market Forecast, 2008-2014 Exhibit 3-58: 2009, Cardiac Resynchronization Therapy Devices Market, Share by Supplier Exhibit 3-59: Cardiac Science's Powerheart AED G3 Plus and Powerheart AED G3 Trainer Exhibit 3-60: Physio-Control's LIFEPAK 15 and LIFEPAK 1000 Automated External Defibrillators Exhibit 3-61: Physio-Control's LIFEPAK CR Plus Automated External Defibrillator Exhibit 3-62: Philips Healthcare's HeartStart OnSite Automated External Defibrillator Exhibit 3-63: Philips Healthcare's HeartStart Automated External Defibrillator Trainer Exhibit 3-64: Philips Healthcare's HeartStart FRx and FR2+ Automated External Defibrillators Exhibit 3-65: Philips Healthcare's HeartStart Home Automated External Defibrillator Exhibit 3-66: ZOLL Medical's LifeVest Wearable Defibrillator Exhibit 3-67: ZOLL Medical's AED Plus Defibrillator Exhibit 3-68: ZOLL Medical's AED Pro Defibrillator Exhibit 3-69: ZOLL Medical's R Series Automated External Defibrillators Exhibit 3-70: Automatic External Defibrillation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-71: Automated External Defibrillators, Market Forecast, 2008-2014 Exhibit 3-72: 2009, Automated External Defibrillators Market, Share by Supplier Exhibit 3-73: Biosense Webster's Navistar ThermoCool Irrigated Tip Catheter/Ablation System Exhibit 3-74: Biosense Webster's CARTO 3 System Exhibit 3-75: Boston Scientific's Blazer II XP Temperature Ablation Catheter Exhibit 3-76: Boston Scientific's SteeroCath-Dx Bi-Directional Steerable Diagnostic Catheter Exhibit 3-77: Medtronic's Arctic Front CryoAblation Catheter System Exhibit 3-78: Medtronic's Freezor Cardiac CryoAblation Catheter Exhibit 3-79: Percutaneous Catheter Ablation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-80: Percutaneous Catheter Ablation Systems, Market Forecast, 2008-2014 Exhibit 3-81: 2009, Percutaneous Catheter Ablation Systems Market, Share by Supplier Exhibit 3-82: AtriCure's Cryo1 Cryo-Ablation Probe Exhibit 3-83: AtriCure's Isolator Multifunctional Pens Exhibit 3-84: AtriCure's AtriClip Gillinov-Cosgrove Left Atrial Appendage Exclusion System Exhibit 3-85: ATS Medical's ATS CryoMaze Surgical Ablation System Exhibit 3-86: Medtronic's Cardioblate BP2 and Gemini Irrigated RF Surgical Ablation Systems Exhibit 3-87: Directed Energy-Based Surgical Ablation, Procedure Volumes Forecast, 2008-2014 Exhibit 3-88: Directed Energy-Based Surgical Ablation Systems, Market Forecast, 2008-2014 Exhibit 3-89: 2009, Directed Energy-Based Surgical Ablation Systems Market, Share by Supplier Exhibit 3-90: Cardiac Rhythm Management Procedures, Combined Procedure Volumes Forecast, 2008-2014 Exhibit 3-91: Cardiac Rhythm Management Products, Combined Market Forecast, 2008-2014 Exhibit 3-92: Cardiac Rhythm Management Products, Combined Market Forecast, by Segment, 2008-2014 Exhibit 3-93: 2009, Cardiac Rhythm Management Products Market, Share by Segment Exhibit 3-94: 2014, Cardiac Rhythm Management Products Market, Share by Segment Exhibit 3-95: 2009, Combined Cardiac Rhythm Management Products Market, Share by Supplier 4. COMPANY PROFILES 4.1 AtriCure, Inc. 4.2 ATS Medical, Inc./Medtronic, Inc. 4.3 Bard Electrophysiology/C.R. Bard, Inc. 4.4 Biosense Webster, Inc./Johnson & Johnson 4.5 Boston Scientific Corporation 4.6 GE Healthcare/General Electric Company 4.7 Medtronic, Inc. 4.8 Philips Healthcare/Royal Philips Electronics NV 4.9 St. Jude Medical, Inc. 4.10 ZOLL Medical Corporation APPENDIX: COMPANY LISTING