What getting a technology into practice looks like

Six cases, each with a date, a site and a name.

Every distributor says it supports market entry. These are the six we point to when a manufacturer asks what that actually means in Slovakia.

Transcatheter mitral valve replacement was reimbursed in Slovakia for a single centre. A device restricted to one site reaches a handful of patients a year and never becomes routine – and the manufacturer carries the cost of a market that never opens.

We had that restriction changed. Tendyne™ is now reimbursed at every centre in Slovakia. Nothing about the device changed; what changed was the paperwork, the argument and the people willing to make it.

What it means for a manufacturer. Reimbursement conditions in Slovakia are not fixed. They are decided in a proceeding, and someone has to run that proceeding.

Extracorporeal life support did not exist as routine practice in Slovakia when we started. It needed sites willing to run it, teams trained to cannulate at three in the morning, protocols, consumables on the shelf and a service engineer who answers the phone.

That took more than thirteen years, and it now extends to ECPR – extracorporeal cardiopulmonary resuscitation – and to paediatric intensive care.

What it means for a manufacturer. Some technologies cannot be sold, only built. If yours is one of them, the question is not whether a distributor can import it but whether they will still be working on it in year ten.

14 August 2025, Stredoslovenský ústav srdcových a cievnych chorôb, Banská Bystrica. Two electrophysiology procedures in patients with atrial fibrillation, performed with the team of prim. MUDr. Adrián Bystriansky, MSc., MPH. High-density electroanatomic mapping of the left atrium was done with the Advisor™ HD Grid catheter and the EnSite™ X 3.1.1 mapping system.

It was the first use of version 3.1.1 in the country – voxel catheter visualisation, tripolar configuration for a more localised signal, and an open platform that does not tie the physician to one catheter family.

What it means for a manufacturer. A software release reached Slovak practice in the same year it shipped, because the site, the training and the specialist in the room were already in place.

5 November 2020, Národný ústav srdcových a cievnych chorôb, Bratislava. The first implantable defibrillator with Bluetooth communication – Gallant™ – was implanted successfully. The patient is followed remotely through their own smartphone.

What it means for a manufacturer. Connected devices need more than an implant: they need the follow-up pathway, the app and the clinic that knows what to do with the data. We put all three in place.

Report in Slovak: Prvý implantovateľný defibrilátor s bluetooth na Slovensku

27 April 2021, Detské kardiocentrum, Bratislava. The first electrophysiology procedure in the new hybrid cardiology intervention lab in the new building of the children’s cardiac centre – a child treated successfully for an arrhythmia.

The second effect mattered as much as the first. Paediatric patients had until then been treated at the National Institute of Cardiovascular Diseases. The new lab freed that capacity for adults. One new site increased access to arrhythmia treatment for both groups at once.

What it means for a manufacturer. This is what we mean when we say we build the lab: room layout, EP technology, the optical network for the equipment, staff training and service. A technology that arrives with a working lab around it starts treating patients on day one.

Report in Slovak: Prvý vyliečený pacient v novej budove Detského kardiocentra

4 August 2026, Národný ústav srdcových a cievnych chorôb, Bratislava. The team of the Department of Arrhythmias and Cardiac Pacing, led by prim. MUDr. Peter Hlivák, PhD., MPH, performed the first implantation of the Aveir™ VR leadless pacemaker. The device goes in through a catheter, straight into the right ventricle – no pocket in the chest, no transvenous leads.

Leadless pacing was not new to the site. They had been working with it for years; what arrived was another generation of it.

What it means for a manufacturer. A new system entered practice at a site that already had years of leadless experience – because that experience was built here first. A market where the groundwork is done absorbs the next generation quickly. The one where it is not spends a year on training before the first case.

Report in Slovak: Bezelektródová kardiostimulácia Aveir™ v Národnom ústave srdcových a cievnych chorôb