論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Medical Cost Analysis of Implantable Cardioverter Defibrillators for Primary Prevention Among Cardiac Arrest Patients.
掲載誌名	正式名：Circulation journal : official journal of the Japanese Circulation Society 略　 称：Circ J ISSNコード：13474820/13469843
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Yusuke Kondo, Toshinori Chiba, Maiko Osawa, Yohei Kawasaki, Tadahiro Goto, James A Coles, Sayaka Ono, Katsuhiko Imai, Masahiko Takagi, Satoaki Matoba, Yoshio Kobayashi, Hiroshi Tada
発行年月	2025/05
概要	BACKGROUND:In Japan, the implantation of implantable cardioverter defibrillators (ICD) for the primary prevention of sudden cardiac death (SCD) is not covered by insurance reimbursement, and the underuse of ICDs has been noted. Therefore, this study analyzed the medical costs incurred due to a lack of primary prevention ICD therapy for SCD.METHODS AND RESULTS:This retrospective cohort study analyzed data from 4 advanced critical care centers between January 2020 and December 2024. From a database of 3,606 cases of cardiac arrest, there were 348 patients with a documented rhythm at the time of arrest that could have been treated with an ICD. Of these patients, 43 (12.4%) had documented evidence of heart failure treatment and were eligible for ICD implantation before experiencing a cardiac arrest. The total mean (±SD) medical cost for these patients was US $11,679±14,666 (¥1,775,150±2,229,272).CONCLUSIONS:In this multicenter retrospective analysis, we identified a subset of patients who were eligible for primary prevention ICD therapy but did not receive it prior to experiencing sudden cardiac arrest. These cases were associated with substantial post-arrest medical costs. Our findings highlight the potential clinical and economic impact of the underutilization of ICDs in Japan and suggest that broader implementation of guideline-directed ICD therapy for primary prevention may reduce both mortality and healthcare expenditure.
DOI	10.1253/circj.CJ-25-0195
PMID	40399076