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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

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 examine...

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Autores principales: Yokoshiki, Hisashi, Shimizu, Akihiko, Mitsuhashi, Takeshi, Furushima, Hiroshi, Sekiguchi, Yukio, Manaka, Tetsuyuki, Nishii, Nobuhiro, Ueyama, Takeshi, Morita, Norishige, Nitta, Takashi, Okumura, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129119/
https://www.ncbi.nlm.nih.gov/pubmed/27920834
http://dx.doi.org/10.1016/j.joa.2016.04.002
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author Yokoshiki, Hisashi
Shimizu, Akihiko
Mitsuhashi, Takeshi
Furushima, Hiroshi
Sekiguchi, Yukio
Manaka, Tetsuyuki
Nishii, Nobuhiro
Ueyama, Takeshi
Morita, Norishige
Nitta, Takashi
Okumura, Ken
author_facet Yokoshiki, Hisashi
Shimizu, Akihiko
Mitsuhashi, Takeshi
Furushima, Hiroshi
Sekiguchi, Yukio
Manaka, Tetsuyuki
Nishii, Nobuhiro
Ueyama, Takeshi
Morita, Norishige
Nitta, Takashi
Okumura, Ken
author_sort Yokoshiki, Hisashi
collection PubMed
description 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.
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spelling pubmed-51291192016-12-05 Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database Yokoshiki, Hisashi Shimizu, Akihiko Mitsuhashi, Takeshi Furushima, Hiroshi Sekiguchi, Yukio Manaka, Tetsuyuki Nishii, Nobuhiro Ueyama, Takeshi Morita, Norishige Nitta, Takashi Okumura, Ken J Arrhythm Original Article 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. Elsevier 2016-12 2016-04-29 /pmc/articles/PMC5129119/ /pubmed/27920834 http://dx.doi.org/10.1016/j.joa.2016.04.002 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Yokoshiki, Hisashi
Shimizu, Akihiko
Mitsuhashi, Takeshi
Furushima, Hiroshi
Sekiguchi, Yukio
Manaka, Tetsuyuki
Nishii, Nobuhiro
Ueyama, Takeshi
Morita, Norishige
Nitta, Takashi
Okumura, Ken
Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
title Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
title_full Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
title_fullStr Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
title_full_unstemmed Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
title_short Trends and determinant factors in the use of cardiac resynchronization therapy devices in Japan: Analysis of the Japan cardiac device treatment registry database
title_sort trends and determinant factors in the use of cardiac resynchronization therapy devices in japan: analysis of the japan cardiac device treatment registry database
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129119/
https://www.ncbi.nlm.nih.gov/pubmed/27920834
http://dx.doi.org/10.1016/j.joa.2016.04.002
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