Cardiac Resynchronization Therapy (CRT) Market

Market Overview

The global cardiac resynchronization therapy market size was valued at USD 6 billion in 2021. It is predicted to reach USD 10.94 billion by 2030 growing at a CAGR of 7% during the forecast period (2022-2030).

Cardiac resynchronization therapy, also known as biventricular pacing, is a method that helps patients with arrhythmias normalize their heartbeat and other disease-related disorders. A pacemaker is frequently implanted below the collarbone during this procedure. Cardiac resynchronization therapy defibrillators and cardiac resynchronization treatment pacemakers are two types of therapy that are commonly used. It is especially beneficial for people with heart failure whose left and right heart lobes do not contract together. Rapid technological advancements are one of the key trends escalating market growth. Adoption of a sedentary lifestyle, the growing geriatric population, and the increasing prevalence of cardiovascular diseases are also stimulating the market's development. 

The global cardiac resynchronization therapy market is divided based on product, end-use, and region.

Market Dynamics

Global Cardiac Resynchronization Therapy Market Drivers

• Increasing Prevalence of Cardiovascular Diseases

Despite developments in prevention & treatment, sudden cardiac death remains a leading cause of mortality and is accountable for nearly half of all deaths from cardiovascular ailments. The increasing prevalence of cardiac disorders and associated risk factors are expected to increase the demand for cardiac resynchronization therapy devices. Heart failure is among the significant reasons for death around the globe. 

According to CDC, as of September 2020, around 6.2 million adults in the U.S. suffer from cardiac conditions. Furthermore, as per the American College of Cardiology Foundation, prevalent cases of cardiovascular diseases nearly doubled from 1990 to 2019. Hence, the increasing prevalence of cardiovascular diseases is anticipated to boost the demand for various treatment options, including cardiac resynchronization therapy devices.

• Rising Sedentary Lifestyle 

Physical inactivity is a primary public concern as it is linked to the second-largest number of deaths, after tobacco consumption, in the U.S. Physical inactivity can lead to morbid obesity and many other chronic diseases, such as cardiac disorders and diabetes. Extended periods of inactivity in otherwise physically active individuals have been commonly observed to increase symptoms of CVD in diabetic and atherosclerotic patients. Major consequences of this lifestyle are cardiac disorders, such as stroke, myocardial infarction, and angina.

According to CDC, as of 2019, about 1 in 4 U.S. individuals sit for over 8 hours a day, 44% do no moderate to vigorous physical activity in a week, and only 4% spend less than 4 hours a day sitting and being active as well. It is anticipated to increase the demand for CRT devices. A sedentary lifestyle can lead to obesity and hypertension, the critical risk factors for CVDs. Obesity continues to be one of the essential public health issues. According to a study published online in Pediatrics, obesity rates among children jumped significantly during the first months of the COVID-19 pandemic. Across the board, there has been a 2% increase in obesity in a year.

Hence, a growing sedentary lifestyle is also estimated to drive the market.

Global Cardiac Resynchronization Therapy Market Restraints

• Product Recall

In February 2021, Medtronic initiated the recall of Viva, Evera, Brava, Amplia, Claria, Visia, and Compia, Implantable Cardioverter Defibrillators (ICDs) and Cardiac Resynchronization Therapy (CRT-Ds), which were distributed between 31 August 2012 and 9 May 2018. The reason for the recall was an unexpected and rapid decrease in battery life.

In June 2021, Boston Scientific Corporation initiated the recall of the INGENIO family of pacemakers and CRT-Ps. These include ADVANTIO DR EL, INGENIO DR EL, and VITALIO DR EL. The devices recalled were manufactured between September 2011 and December 2018 and distributed between 1 November 2011 and 1 August 2020. Around Forty-eight thousand devices were recalled in the U.S. The reason for the recall was the risk of the device transitioning to safety mode.

In February 2018, Medtronic recalled certain ICDs and CRT-Ds due to a manufacturing defect. This defect caused an out-of-specification gas mixture inside the device. Hence, it would prevent the device from delivering the electrical shock required to pace a patient's heartbeat or revive the patient in case of a cardiac arrest. This recall affected devices with product codes LWS and NIK that were manufactured between 13 July 2013 and 8 August 2017. Around 48 units in the U.S. were recalled during this process. Hence, an increasing number of product recalls is expected to impact the adoption negatively of cardiac resynchronization therapy devices, restricting the market over the projected period.

Global Cardiac Resynchronization Therapy Market Opportunities

• Technological Advancements

CRTs have been upgraded with numerous new features, such as longer battery life and smaller size. As a result, vendors have been focusing more on the development of innovative CRTs. For instance, in January 2018, MicroPort Scientific Corporation launched Smart Touch, a new tablet-based programmer in Europe. The product is used with cardiac resynchronization devices, pacemakers, and defibrillators. 

In March 2017, Biotronik released a new lineup of Cardiac Resynchronization Therapy (CRT) devices, called the Silvia series, thus extending the company's product offerings. Furthermore, technical developments and digitization in healthcare technologies, as well as an increase in developing markets with an expanding older population profile, will generate new opportunities for the cardiac resynchronization treatment demand during the anticipated period of 2022-2030.

Regional Analysis

Based on regions, the global cardiac resynchronization therapy market share is segmented into Europe, North America, Asia-Pacific, Middle East and Africa, and Latin America.

The North America Cardiac Resynchronization Therapy market is anticipated to maintain its dominance during the forecast period due to its increasing geriatric population and growing regulatory approvals. The North America cardiac resynchronization therapy (CRT) market was valued at USD 2,311 Million in 2021 and. It is expected to reach an expected value of USD 4,167 Million by 2030 at a CAGR of 7% during the forecast period. The growth can be attributed to various factors such as increasing awareness about the benefits of cardiovascular devices, high disposable income, and the presence of advanced healthcare infrastructure. 

In addition, several medical device vendors present in this region are involved in providing cardiovascular care globally. These companies are focused on launching new and advanced products, including features such as miniaturization & increased battery life, which is anticipated to further drive market growth.

The Asia-Pacific market is projected to grow at the fastest CAGR over the next few years. The Asia-Pacific cardiac resynchronization therapy (CRT) market was valued at USD 1,231 Million in 2021. It is expected to reach an expected value of USD 2,487 Million in 2030 at a CAGR of 8% during the forecast period. This is due to rising medical infrastructure, an older population, positive financial situations, strategic actions by significant firms, and an increased incidence of heart disorders.

Developed markets, such as Japan and Australia, are also rapidly adopting new technological advancements in these devices. For instance, remote monitoring in cardiac implantable devices was found to be adopted rapidly across Asia-Pacific, especially in CRT/CRTDs, despite having greater cost. In New Zealand, data on cardiac implantable electronic devices was studied between 2014 and 2017. 155 patients received CRT-D implants, while 175 received CRT-P implants during the period. Patients who received a new CRT-P were found to be more likely to be female and older, compared to new primary prevention CRT-D implants.

Segmental Analysis

The global cardiac resynchronization therapy market share is divided based on product, end-use, and regions. 

The global cardiac resynchronization therapy (CRT) devices are segmented into CRT defibrillators and CRT pacemakers. The global CRT-D market was valued at USD 3,411 Million in 2021. It is expected to be valued at USD 5,534 Million by 2030, at a CAGR of 6% during the forecast period. CRT Defibrillator (CRT-D) is intended to resynchronize the right and left ventricles in patients with congestive heart failure to provide ventricular cardioversion/defibrillation & ventricular anti-tachycardia pacing. 

This segment dominated the market in 2021 owing to rising product advancements, growing initiatives by key companies, and increasing product adoption by end-users. For example, Abbott acquired CE Marking for their Gallant ICDs and CRT-D devices in February 2020. These products integrate with Abbott's myMerlinPuls App and enable real time monitoring, expanding the company's products. The Gallant CRT-D system's MultiPoint Pacing and SyncAV features boost patient reaction to CRT treatment. This aided the company's expansion plans.

The global cardiac resynchronization therapy market is broadly categorized into hospitals, cardiac centers, and others based on the end-use segment. The hospitals segment dominated the end-use part. The hospitals segment was valued at USD 3,045 Million in 2021 and is expected to grow at a CAGR of 7% during the forecast period, to reach an expected value of USD 5,595 Million in 2030. The hospitals segment dominated the end-use part, owing to increasing facilities and medical devices, such as cardiac resynchronization defibrillators & cardiac resynchronization pacemakers available in hospitals for treating & diagnosing cardiovascular disease.

The rising demand for CRT devices for patients with cardiovascular disease and congestive heart failure is another factor propelling the market growth. According to the Australia Institute of Health and Welfare, 6.2% of adults aged 18 & above had one or more conditions in relation to heart and stroke in 2017–2018. Such increasing prevalence of cardiovascular disease leads to high demand for devices to correct cardiac rhythm, which drives the market growth. Moreover, the cardiac centers segment registered the fastest growth in the cardiac resynchronization therapy (CRT) market.

Impact of covid-19

COVID-19 is a contagious respiratory disease that has affected millions of people worldwide. The pandemic has prompted the healthcare industry to undertake significant actions, with companies, countries, and organizations racing to develop therapeutic & preventive interventions. Countries, governments, and businesses have been implementing strategies and responding accordingly to address the situation at hand. In many countries, the impact of COVID-19 was amplified through other occurrences, such as the African swine fever or wildfires.

The CRT products sector, like many industries, has been severely impacted. COVID-19 has had a substantial influence on the market, including supply chain problems, a drop in sales, a reduction in prices due to the cancellation of elective surgeries, and operational challenges. For example, Abbott, a worldwide provider in the cardiac rhythm management device market, reported a reduction in cardiovascular sales growth in 2020.

Market Recovery Timeline

Past the initial panic and uncertainty caused by COVID-19, corporations and organizations immediately took constructive measures to aid the recovery of the market and enterprises. Among many of the methods employed were policy and financial stimulation, constraint flexibility, conditional exclusions, and other development initiatives. For example, Abbott launched four diagnostic tests for COVID-19 in 2020. The high returns from these sales offset the loss in revenue in different business segments.

The American College of Cardiology (ACC), the Canadian Association of Interventional Cardiology (CAIC), and other North American cardiology societies provided directives for reinstating intrusive cardiovascular operations in an efficient and responsible manner after the apex of COVID-19 has elapsed. These rules aided the economic recovery of CRT devices. 

The COVID-19 pandemic accelerated the adoption of telehealth to monitor and manage patients with arrhythmias. This trend is expected to continue to post the pandemic. Remote monitoring has emerged as a tool for lowering the risk of exposure to the virus, especially in the case of cardiac patients. Overall, the pandemic has significantly impacted the cardiac rhythm management devices industry and created opportunities for those willing to leverage them.

Recent Developments

• In September 2021, Abbott acquired Walk Vascular, LLC, a medical device company specializing in minimally invasive mechanical aspiration thrombectomy systems. This acquisition enhanced its endovascular product portfolio.
• In October 2021, Boston Scientific Corporation agreed to acquire Baylis Medical Company, Inc. This acquisition added to its structural heart and electrophysiology portfolios and was expected to be valued at USD 1.75 billion..
• In May 2020, Biotronik, Inc. partnered with Acutus Medical to provide a comprehensive portfolio for catheter-based treatment of cardiac arrhythmias, such as electrophysiology, mapping, and ablation products, across select markets, including Europe & Asia. This supported the company’s growth strategy and expanded its portfolio.
• In October 2021, MicroPort acquired Hemovent GmbH, a Germany-based ECLS company, for USD 138.71 million. This expanded its operations in Germany.
• In June 2021, MicroPort CRM launched Borea and Alizea pacemakers with Bluetooth connectivity and streamlined remote monitoring in Europe, after receiving CE mark approval.