TY - JOUR
T1 - Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan
T2 - Analysis of the Japan cardiac device treatment registry database
AU - Members of the Implantable Cardioverter-Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society
AU - Yokoshiki, Hisashi
AU - Shimizu, Akihiko
AU - Mitsuhashi, Takeshi
AU - Furushima, Hiroshi
AU - Sekiguchi, Yukio
AU - Manaka, Tetsuyuki
AU - Nishii, Nobuhiro
AU - Ueyama, Takeshi
AU - Morita, Norishige
AU - Nitta, Takashi
AU - Okumura, Ken
N1 - Funding Information:
We thank all the members of the JHRS who registered data in the JCDTR on a voluntary basis. As of January 30, 2016, 367 facilities in Japan had enrolled at least one patient. The list of the facilities that enrolled more than 100 patients (89 facilities in alphabetical order) is below. Akita Medical Center, Anjo Kosei Hospital, Dokkyo Medical University, Edogawa Hospital, Fujita Health University, Fukushima Medical University, Gifu University, Gunma University, Hirosaki University, Hokkaido University Hospital, Hokko Memorial Hospital, Hyogo College of Medicine, IMS Katsushika Heart Center, Ishinomaki Red Cross Hospital, Itabashi Chuo Medical Center, Japanese Red Cross Society Kyoto Daini Hospital, Japanese Red Cross Wakayama Medical Center, JCHO Hokkaido Hospital, JCHO Kyushu Hospital, Jichi Medical University, Juntendo University, Juntendo University Urayasu Hospital, Kakogawa East City Hospital, Kameda Medical Center, Kanazawa Medical University, Keio University, Kitasato University, Kochi Health Science Center, Kokura Memorial Hospital, Komaki City Hospital, Kumamoto Red Cross Hospital, Kumamoto University, Kurashiki Chuo Hospital, Kyorin University, Kyoto Prefectural University of Medicine, Kyoto-Katsura Hospital, Maebashi Red Cross Hospital, Matsue Red Cross Hospital, Matsumoto Kyoritsu Hospital, Mito Saiseikai General Hospital, Nagasaki University, Nagoya University, National Hospital Organization Kagoshima Medical Center, National Hospital Organization Shizuoka Medical Center, Nihon University, Nippon Medical University, Odawara Municipal Hospital, Okayama University, Okinawa Prefectural Chubu Hospital, Osaka City General Hospital, Osaka City University, Osaka Medical College, Osaka Police Hospital, Osaka University, Saiseikai Fukuoka General Hospital, Saiseikai Kumamoto Hospital, Saiseikai Shimonoseki General Hospital, Saiseikai Yokohamashi Tobu Hospital, Saitama Red Cross Hospital, Sakurabashi Watanabe Hospital, Seirei Hamamatsu General Hospital, Sendai Kosei Hospital, Shiga University of Medical Science, Shinshu University, Shizuoka municipal Hospital, Showa General Hospital, St. Luke׳s International Hospital, St. Marianna University School of Medicine, Takeda Hospital, Tenri Hospital, The University of Tokyo, Toho University, Tokai University, Tokyo Medical University, Tokyo Metropolitan Hiroo Hospital, Tokyo Metropolitan Tama Medical Center, Tokyo Women׳s Medical University, Tottori University, Toyohashi Heart Center, Tsuchiura Kyodo General Hospital, University of Fukui, University of Miyazaki, University of Occupational and Environmental Health, University of Tsukuba, Yamagata Prefectural Central Hospital, Yamagata University, Yamaguchi University, Yamanashi Prefectural Central Hospital, Yokohama Rosai Hospital. Appendix A
Publisher Copyright:
© 2016 The Authors
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background The choice of cardiac resynchronization therapy device, with (CRT-D) or without (CRT-P) a defibrillator, in patients with heart failure largely depends on the physician׳s discretion, because it has not been established which subjects benefit most from a defibrillator. Methods We examined the annual trend of CRT device implantations between 2006 and 2014, and evaluated the factors related to the device selection (CRT-D or CRT-P) for primary prevention of sudden cardiac death in patients with heart failure by analyzing the Japan Cardiac Device Treatment Registry (JCDTR) database from January 2011 and August 2015 (CRT-D, n=2714; CRT-P, n=555). Results The proportion of CRT-D implantations for primary prevention among all the CRT-D recipients was more than 70% during the study period. The number of CRT-D implantations for primary prevention reached a maximum in 2011 and decreased gradually between 2011 and 2014, whereas CRT-P implantations increased year by year until 2011 and remained unchanged in recent years. Multivariate analysis identified age (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.90–0.95, P<0.0001), male sex (OR 1.99, 95% CI 1.28–3.11, P<0.005), reduced left ventricular ejection fraction (LVEF) (OR 0.96, 95% CI 0.94–0.98, P<0.0001), and non-sustained ventricular tachycardia (NSVT) (OR 2.85, 95% CI 1.87–4.35, P<0.0001) as independent factors favoring the choice of CRT-D. Conclusions Younger age, male sex, reduced LVEF, and a history of NSVT were independently associated with the choice of CRT-D for primary prevention of sudden cardiac death in patients with heart failure in Japan.
AB - Background The choice of cardiac resynchronization therapy device, with (CRT-D) or without (CRT-P) a defibrillator, in patients with heart failure largely depends on the physician׳s discretion, because it has not been established which subjects benefit most from a defibrillator. Methods We examined the annual trend of CRT device implantations between 2006 and 2014, and evaluated the factors related to the device selection (CRT-D or CRT-P) for primary prevention of sudden cardiac death in patients with heart failure by analyzing the Japan Cardiac Device Treatment Registry (JCDTR) database from January 2011 and August 2015 (CRT-D, n=2714; CRT-P, n=555). Results The proportion of CRT-D implantations for primary prevention among all the CRT-D recipients was more than 70% during the study period. The number of CRT-D implantations for primary prevention reached a maximum in 2011 and decreased gradually between 2011 and 2014, whereas CRT-P implantations increased year by year until 2011 and remained unchanged in recent years. Multivariate analysis identified age (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.90–0.95, P<0.0001), male sex (OR 1.99, 95% CI 1.28–3.11, P<0.005), reduced left ventricular ejection fraction (LVEF) (OR 0.96, 95% CI 0.94–0.98, P<0.0001), and non-sustained ventricular tachycardia (NSVT) (OR 2.85, 95% CI 1.87–4.35, P<0.0001) as independent factors favoring the choice of CRT-D. Conclusions Younger age, male sex, reduced LVEF, and a history of NSVT were independently associated with the choice of CRT-D for primary prevention of sudden cardiac death in patients with heart failure in Japan.
KW - Cardiac resynchronization therapy
KW - Defibrillator
KW - Heart failure
KW - Primary prevention
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U2 - 10.1016/j.joa.2016.04.002
DO - 10.1016/j.joa.2016.04.002
M3 - Article
AN - SCOPUS:84964661136
SN - 1880-4276
VL - 32
SP - 486
EP - 490
JO - Journal of Arrhythmia
JF - Journal of Arrhythmia
IS - 6
ER -