Regional and socioeconomic disparities in the diagnosis of primary electrical diseases in a universal healthcare system: a nationwide Danish study
Primary electrical diseases (PED), including Long QT syndrome (LQTS), Brugada syndrome (BrS), and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT), are rare inherited heart rhythm disorders that can increase the risk of sudden cardiac death. Early diagnosis is important because appropriate treatment, regular follow-up, and screening of family members can help prevent life-threatening events (such as cardiac arrest). Denmark has a publicly funded healthcare system with specialised inherited cardiac clinics. This study investigated whether geographic and socioeconomic factors, such as income or education, were associated with differences in the diagnosis and management of PED across Denmark.
In this nationwide Danish study, 1,132 individuals diagnosed with PED between 2007 and 2024 were compared with people of the same age and sex from the general population. The researchers examined differences in the number of diagnosed patients across regions, distance to specialised inherited cardiac clinics, treatment patterns, and socioeconomic factors.
The study found that the number of diagnosed patients varied across Denmark. The highest known incidence was observed in the North Denmark Region, while the lowest was found in the Central Denmark Region. More patients were diagnosed in capital cities than in other city types. Patients with PED also lived closer to specialized inherited cardiac clinics than people in the general population, suggesting that nearness to expert centres may affect the likelihood of diagnosis. Anxiety and other psychiatric disorders were more common among patients than in the general population. Most socioeconomic differences were small, although immigrants were underrepresented among diagnosed patients.
This study shows that differences in geography and healthcare organisation may influence the diagnosis and management of inherited heart rhythm disorders, even within a publicly funded healthcare system. Improving awareness of these conditions, strengthening referral pathways, and ensuring timely access to specialised inherited cardiac clinics may help identify more patients earlier, improve care, and reduce the risk of sudden cardiac death. Although this study cannot determine the exact reasons for the regional differences, it highlights areas where future research and healthcare improvements may help ensure timely diagnosis and access to specialised care.
Bhardwaj P, Winkel BG, Dinesen RB, Torp-Pedersen C, Jacobsen SB, Wilde AAM, Hansen CJ, Tfelt-Hansen J. Regional and Socioeconomic Disparities in the Diagnosis of Primary Electrical Diseases in a Universal Healthcare System: A Nationwide Danish Study. Eur Heart J Qual Care Clin Outcomes. 2026 Apr 18:qcag069. doi: 10.1093/ehjqcco/qcag069. Epub ahead of print. PMID: 41999290.
Prepared by Priya Bhardwaj and Lorraine McGlinskey