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Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan : Analysis of the Japan cardiac device treatment registry database

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/64758

Title: Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan : Analysis of the Japan cardiac device treatment registry database
Authors: Yokoshiki, Hisashi Browse this author →KAKEN DB
Shimizu, Akihiko Browse this author
Mitsuhashi, Takeshi Browse this author →KAKEN DB
Furushima, Hiroshi Browse this author
Sekiguchi, Yukio Browse this author →KAKEN DB
Manaka, Tetsuyuki Browse this author
Nishii, Nobuhiro Browse this author →KAKEN DB
Ueyama, Takeshi Browse this author
Morita, Norishige Browse this author
Nitta, Takashi Browse this author →KAKEN DB
Okumura, Ken Browse this author →KAKEN DB
Keywords: Cardiac resynchronization therapy
Defibrillator
Primary prevention
Heart failure
Issue Date: Dec-2016
Publisher: Elsevier
Journal Title: Journal of arrhythmia
Volume: 32
Issue: 6
Start Page: 486
End Page: 490
Publisher DOI: 10.1016/j.joa.2016.04.002
Abstract: 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.
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article
URI: http://hdl.handle.net/2115/64758
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 横式 尚司

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