학술논문
Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
Document Type
Report
Author
Source
Journal of Arrhythmia. December 2016, Vol. 32 Issue 6, p486, 5 p.
Subject
Language
English
ISSN
1880-4276
Abstract
Introduction Cardiac resynchronization therapy (CRT) is an effective option for the treatment of moderate to severe heart failure [1–6]. The COMPANION trial [2] found that CRT with a defibrillator (CRT‐D) [...]
: 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 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.
: 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 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.