| 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 | Nationwide Lifespan Trends in Cardiac Implantable Electronic Device Strategies in Japan: Age-Dependent Changes in Transvenous and Epicardial Systems. |
| 掲載誌名 | 正式名：Journal of arrhythmia 略 称：J Arrhythm ISSNコード：18804276/18804276 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 42(5),pp.e70408 |
| 著者・共著者 | Aya Miyazaki, Gaku Izumi, Shuhei Fujita, Tsugutoshi Suzuki, Hiroshi Suzuki, Jun Yoshimoto, Keiko Toyohara, Yasunobu Hayabuchi, Masahiko Takagi |
| 発行年月 | 2026/08 |
| 概要 | BACKGROUND:Nationwide epidemiological studies of cardiac implantable electronic devices (CIEDs) encompassing multiple device types and strategies remain limited in Japan, particularly regarding epicardial lead use and pediatric populations.METHODS:We performed the first nationwide analysis of CIED implantation trends using the National Database of Health Insurance Claims, including transvenous (TV)/epicardial (Epi) systems for pacemakers, implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT), and CRT-defibrillators (CRTDs), as well as leadless pacemakers, subcutaneous ICDs (S-ICDs), and epicardial lead use. Epicardial lead and pediatric characteristics were supplemented using industry data.RESULTS:In fiscal year 2023, implantation rates per 100 000 population were 29.69 for TV-pacemakers, 7.06 for leadless pacemakers, 2.42 for TV-ICDs, 0.889 for S-ICDs, 1.20 for TV-CRT, and 1.69 for TV-CRTDs. Rates for epicardial systems were lower, at 0.173 for Epi-pacemakers, 0-0.007 for Epi-ICDs, 0.024 for Epi-CRT, and 0.027 for Epi-CRTDs, while epicardial lead use was 0.545. S-ICD use increased across age groups, whereas TV-ICD implantation declined (all p < 0.001). Implantation of TV and leadless pacemakers, TV-CRT, and TV-CRTDs increased over time (all p < 0.001). Epicardial lead use showed a bimodal age distribution, peaking in pediatric and elderly populations, and declined in older adults while remaining stable in children and adults aged 20-49 years (p < 0.001). Pediatric CIED volumes were low, with several ICD, CRT, and CRTD procedures annually.CONCLUSIONS:CIED strategies in Japan demonstrate age-dependent variation. Epicardial systems remain indispensable in pediatric and congenital heart disease care, whereas alternative technologies are increasingly adopted in older adult populations, reflecting evolving lifespan-related device strategies. |
| DOI | 10.1002/joa3.70408 |
| PMID | 42682907 |