학술논문
Cardiac resynchronization therapy with a defibrillator in non-ischemic and ischemic patients for primary and secondary prevention of sudden cardiac death: Analysis of the Japan cardiac device treatment registry database.
Document Type
Academic Journal
Author
Yokoshiki H; Department of Cardiovascular Medicine Sapporo City General Hospital Sapporo Japan.; Shimizu A; UBE Kohsan Central Hospital Ube Japan.; Mitsuhashi T; Department of Cardiovascular Medicine Hoshi General Hospital Koriyama Japan.; Ishibashi K; Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.; Kabutoya T; Division of Cardiovascular Medicine, Department of Medicine Jichi Medical University School of Medicine Shimotsuke Japan.; Yoshiga Y; Division of Cardiology, Department of Medicine and Clinical Science Yamaguchi University Graduate School of Medicine Yamaguchi Japan.; Kondo Y; Department of Cardiovascular Medicine Chiba University Graduate School of Medicine Chiba Japan.; Abe H; Department of Heart Rhythm Management University of Occupational and Environmental Health Kitakyushu Japan.; Shimizu W; Department of Cardiovascular Medicine Nippon Medical School Bunkyo City Japan.
Source
Publisher: Wiley Country of Publication: Japan NLM ID: 101263026 Publication Model: eCollection Cited Medium: Print ISSN: 1880-4276 (Print) Linking ISSN: 18804276 NLM ISO Abbreviation: J Arrhythm Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1880-4276
Abstract
Background: Panoramic studies in patients with cardiac resynchronization therapy with a defibrillator (CRT-D) focusing on the etiology and indication are scarce. Besides, a controversy exists regarding requirement of a defibrillator in non-ischemic patients for primary prevention with CRT.
Methods: Annual trends of de novo CRT-D implantations from 2011 to 2020 and outcomes of those between January 2011 and August 2015 were analyzed from the Japan cardiac device treatment registry (JCDTR) and New JCDTR database.
Results: From 2011 to 2020, 8062 CRT-D recipients were registered, whose dominant indication was primary prevention of sudden cardiac death with a steady rate of about 70%. There was no significant temporal change of the proportion of non-ischemic patients being about 70% and 65% for primary and secondary prevention, respectively. Non-ischemic patients for primary prevention were associated with increased odds of appropriate ICD therapy [adjusted hazard ratio (aHR): 1.66; 95% confidence interval (CI): 1.01-2.75; p = .047] and reduced odds of any death (aHR: 0.66; 95% CI: 0.44-0.99; p = .046) as compared to ischemic patients.
Conclusions: Proportion of non-ischemic etiology was much higher than that of ischemic one in the CRT-D cohort. Based on the higher odds of appropriate ICD therapy, non-ischemic patients for primary prevention appear to be prudently selected in Japan.
Competing Interests: All authors declare no conflict of interest related to this study.
(© 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)
Methods: Annual trends of de novo CRT-D implantations from 2011 to 2020 and outcomes of those between January 2011 and August 2015 were analyzed from the Japan cardiac device treatment registry (JCDTR) and New JCDTR database.
Results: From 2011 to 2020, 8062 CRT-D recipients were registered, whose dominant indication was primary prevention of sudden cardiac death with a steady rate of about 70%. There was no significant temporal change of the proportion of non-ischemic patients being about 70% and 65% for primary and secondary prevention, respectively. Non-ischemic patients for primary prevention were associated with increased odds of appropriate ICD therapy [adjusted hazard ratio (aHR): 1.66; 95% confidence interval (CI): 1.01-2.75; p = .047] and reduced odds of any death (aHR: 0.66; 95% CI: 0.44-0.99; p = .046) as compared to ischemic patients.
Conclusions: Proportion of non-ischemic etiology was much higher than that of ischemic one in the CRT-D cohort. Based on the higher odds of appropriate ICD therapy, non-ischemic patients for primary prevention appear to be prudently selected in Japan.
Competing Interests: All authors declare no conflict of interest related to this study.
(© 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)