Implantable Cardioverter-Defibrillator for Primary Prevention in Asia

Multicenter prospective observational study to clarify the current status and clinical outcome in Japanese patients who have an indication for implantable cardioverter defibrillator (ICD) or wearable cardioverter defibrillator (WCD) (TRANSITION JAPAN‐ICD/WCD study): Rationale and design of a prospective, multicenter, observational, comparative study

“…Nevertheless, underuse of ICD has been reported especially in Asia including Japan 9,10 . Several factors contribute to this underutilization, including physicians' awareness, patients' consciousness, and various social factors, such as those associated with aging and economic considerations in Japan 11–16 . However, in recent years, studies undertaken in Japan, such as the HINODE trial, have shown mortality rates and rates of ventricular arrhythmias as high as those in Western countries 17 .…”

Primary Prevention of Sudden Cardiac Death in Asia

“…Two important reviews in this issue of JACC: Asia provide insights on this important topic. Younis and Wilkoff 3 and Ueda et al 4 reviewed the U.S. 5 and European guidelines 6 for ICD use in primary prevention of SCD in ischemic cardiomyopathy (ICM). ICDs have been shown to be life-saving in major randomized controlled trials and also in meta-analyses, 7 based on randomized trials performed between 1996 and 2005.…”

“…The authors 3 also reviewed ICD therapy in nonischemic cardiomyopathy (NICM), including the more recent mortality neutral results of the DANISH (Defibrillator Implantation in Patients with Non Ischemic Systolic Heart Failure) trial. 14 Again, the overall meta-analysis 15 documents the benefit of mortality reduction in primary prevention using ICDs over OMT.…”

“…Uede et al 4 presented more granular data on the unsolved issues of ICD underutilization in Asia. They discussed population differences in underlying heart disease for heart failure and the rate of appropriate ICD therapy compared with Western countries.…”