Survival and Heart Failure Hospitalization in Patients With Cardiac Resynchronization Therapy With or Without a Defibrillator for Primary Prevention 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; Okamura, Hideo; Nitta, Takashi; Hirao, Kazuyuki; Okumura, Ken

doi:10.1253/circj.cj-17-0234

Cited by 20 publications

(22 citation statements)

References 48 publications

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“…They were male gender, younger age, reduced LVEF, and a history of NSVT. In contrast to the COMPANION and REVERSE studies, no significant superiority of CRT‐D to CRT‐P, in terms of reducing the risk of death, was observed in a recent study of the JCDTR after adjusting the clinical variables . This may be in part due to an incomplete adjustment of the study populations.…”

Section: Discussionmentioning

confidence: 78%

“…In Hokkaido University Hospital, the protocol was approved on September 20, 2012, by the Ethics Committee (approval number: 012‐0156). Among 2714 CRT‐D recipients for primary prevention with an implantation date between January 2011 and August 2015, the follow‐up data were available in 620 patients as of September 16, 2015 . Information regarding presence or absence of NSVT had been registered at the CRT‐D implantation in 269 patients (43%).…”

Section: Methodsmentioning

confidence: 99%

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Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Yokoshiki

Shimizu

Mitsuhashi

et al. 2018

Journal of Arrhythmia

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BackgroundWhether nonsustained ventricular tachycardia (NSVT) is a marker of increased risk of sustained ventricular tachyarrhythmias (VTAs) remains to be established in patients receiving cardiac resynchronization therapy with a defibrillator (CRT‐D) for primary prevention.MethodsAmong the follow‐up data of the Japan cardiac device treatment registry (JCDTR) with an implantation date between January 2011 and August 2015, information regarding a history of NSVT before the CRT‐D implantation for primary prevention had been registered in 269 patients. Outcomes were compared between two groups with and without NSVT: NSVT group (n = 179) and No NSVT group (n = 90).ResultsThere was no significant difference with regard to age, gender, and NYHA class between the two groups. Left ventricular ejection fraction (LVEF) was 25.6% in the NSVT group and 28.0% in the No NSVT group (P = .046). The rate of appropriate therapy at 24 months was 26.0% and 18.4% in the NSVT and No NSVT groups (P = .22), respectively. Survival free from heart failure death was reduced in the NSVT group, as compared with the No NSVT group, with the rate of 90.2% vs 97.2% at 24 months (P = .030). A multivariate analysis identified a history of NSVT, anemia, and no use of angiotensin‐converting enzyme inhibitor (ACEI) or angiotensin‐receptor blocker (ARB) as predictors of heart failure death.Conclusions NSVT appears to be a surrogate marker of severe heart failure rather than a substrate for subsequent sustained VTAs in patients with CRT‐D for primary prevention.

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Section: Discussionmentioning

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Yokoshiki

Shimizu

Mitsuhashi

et al. 2018

Journal of Arrhythmia

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“…2,8,9 Several observational studies could not identify symptomatic heart failure patients who benefit more from CTR-D than CRT-P, as there were significant demographic and morbid differences between the two patient groups. 14,18,19 Despite this, the superiority of CRT-D to CRT-P was reported in HFrEF patients with ischemic cardiomyopathy, [20][21][22][23] those with nonischemic cardiomyopathy having left ventricular midwall fibrosis 24 and those with the Goldenberg (MADIT) risk scores 0-2. 25 More recently, CRT-D…”

Section: Discussionmentioning

confidence: 99%

“…First, clinical outcomes are not shown in this study, but we reported several outcomes in other studies. 19,30 Second, the rate of registration with the JCDTR is decreasing as evident from the data of JADIA. For example, ratio of registration of the JCDTR to that of JADIA (JCDTR/ JADIA ratio) was 57.0% for ICD and 49.3% for CRT-D in 2011, but it declined gradually.…”

Section: Study Limitationsmentioning

confidence: 95%

Trends in the use of implantable cardioverter‐defibrillator and cardiac resynchronization therapy device in advancing age: Analysis of the Japan cardiac device treatment registry database

Yokoshiki

Shimizu²,

Mitsuhashi

et al. 2020

Journal of Arrhythmia

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Background Trends of de novo implantation of cardiac implantable electronic devices (CIEDs) including implantable cardioverter‐defibrillator (ICD) and cardiac resynchronization therapy with a defibrillator (CRT‐D) or pacemaker (CRT‐P) in advancing age are unknown. Methods Analysis of data from the Japan cardiac device treatment registry (JCDTR) with an implantation date between January 2006 and December 2016 was performed focusing on advancing age of ≧75 years. Results The cohort included 17 564 ICD, 9470 CRT‐D and 1087 CRT‐P recipients for de novo implantation. The rate of patients ≧75 years of age increased from 17.1% to 20.5% in ICD implantation (P = .052), from 19.7% to 30.0% in CRT‐D implantation (P < .0001), and from 40.0% to 64.0% in CRT‐P implantation (P = .17). There was an apparent increase in the percentage of nonischemic patients aged ≧75 years receiving ICD (10.9% in 2006 to 16.4% in 2016, P = .0008) and CRT‐D (17.1% in 2006 to 27.8% in 2016, P = .0001). The implantation for primary prevention ICD (P = .059) and CRT‐D (P = .012) was also associated with a temporal increase in the percentage of patients aged ≧75 years. Conclusions Proportion of patients ≧75 years of age for de novo CIED implantation gradually increased from 2006 to 2016, presumably because of the growing number of nonischemic cardiomyopathy and heart failure patients requiring primary prevention of sudden cardiac death.

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“…Patients with HF at high risk of sudden cardiac death (SCD) due to ventricular arrhythmia may be fitted with an implantable cardioverter-defibrillator (ICD) [ 58 ]. Recent guidelines recommend this option in patients with a life expectancy of > 1 year [ 17 , 59 ].…”

Section: End-of-life Care For Patients With Device Therapymentioning

confidence: 99%

Palliative and end-of-life care for heart failure patients in an aging society

Okumura

Sawamura

Murohara

2018

Korean J Intern Med

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The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards. The decision of whether to perform cardiopulmonary resuscitation in the event of an emergency is challenging, especially in elderly HF patients, because of the difficulty in accurately predicting the prognosis of the condition. Furthermore, advanced HF patients are often fitted with a device, and device deactivation at the end of life is a complicated process. Treatment strategies should thus be discussed by multi-disciplinary teams, including palliative experts, and should consider patient directives to address the problems discussed above. Open communication with the HF patient regarding the expected prognosis, course, and treatment options will serve to support the patient and aid in future planning.

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Survival and Heart Failure Hospitalization in Patients With Cardiac Resynchronization Therapy With or Without a Defibrillator for Primary Prevention in Japan　― Analysis of the Japan Cardiac Device Treatment Registry Database ―

Cited by 20 publications

References 48 publications

Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Trends in the use of implantable cardioverter‐defibrillator and cardiac resynchronization therapy device in advancing age: Analysis of the Japan cardiac device treatment registry database

Palliative and end-of-life care for heart failure patients in an aging society

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Survival and Heart Failure Hospitalization in Patients With Cardiac Resynchronization Therapy With or Without a Defibrillator for Primary Prevention in Japan ― Analysis of the Japan Cardiac Device Treatment Registry Database ―

Cited by 20 publications

References 48 publications

Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Prognostic significance of nonsustained ventricular tachycardia in patients receiving cardiac resynchronization therapy for primary prevention: Analysis of the Japan cardiac device treatment registry database

Trends in the use of implantable cardioverter‐defibrillator and cardiac resynchronization therapy device in advancing age: Analysis of the Japan cardiac device treatment registry database

Palliative and end-of-life care for heart failure patients in an aging society

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Product

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Survival and Heart Failure Hospitalization in Patients With Cardiac Resynchronization Therapy With or Without a Defibrillator for Primary Prevention in Japan　― Analysis of the Japan Cardiac Device Treatment Registry Database ―