Open AccessTrends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
Author(s) -
Yokoshiki Hisashi,
Shimizu Akihiko,
Mitsuhashi Takeshi,
Furushima Hiroshi,
Sekiguchi Yukio,
Manaka Tetsuyuki,
Nishii Nobuhiro,
Ueyama Takeshi,
Morita Norishige,
Nitta Takashi,
Okumura Ken
Publication year - 2016
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2016.04.002
Subject(s) - medicine , cardiac resynchronization therapy , heart failure , database , emergency medicine , ejection fraction , computer science
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.