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

• Published in: Journal of arrhythmia Vol. 32; no. 6; pp. 486 - 490
• Main Authors: Yokoshiki, Hisashi, Shimizu, Akihiko, Mitsuhashi, Takeshi, Furushima, Hiroshi, Sekiguchi, Yukio, Manaka, Tetsuyuki, Nishii, Nobuhiro, Ueyama, Takeshi, Morita, Norishige, Nitta, Takashi, Okumura, Ken
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.12.2016; Elsevier; Wiley
• Subjects: Analysis; Anticoagulants; Cardiac arrhythmia; Cardiac patients; Cardiac resynchronization therapy; Cardiovascular; Cardiovascular disease; Cardiovascular equipment; Defibrillator; Disease prevention; Enzymes; Heart; Heart failure; Hospitals; Hypertension; Ischemia; Mortality; Original; Pacemakers; Patients; Prevention; Primary prevention; Tachycardia; Trends; Japan; Heart failure; Primary prevention; Cardiac resynchronization therapy; Defibrillator
• ISSN: 1880-4276; 1883-2148
• 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.