Regional Disparities in Transvenous Lead Extraction for Cardiac Implantable Electronic Device Infection in Japan　― A Descriptive Study Using the National Database Open Data ―

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  • Togashi Shintaro
    Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health Department of Nursing Care, Sendai Kousei Hospital
  • Isawa Tsuyoshi
    Department of Cardiology, Sendai Kousei Hospital
  • Honda Taku
    Department of Cardiology, Sendai Kousei Hospital
  • Furuya Kenichi
    Department of Medical Technology, Sendai Kousei Hospital
  • Yamaya Kazuhiro
    Department of Cardiovascular Surgery, Sendai Kousei Hospital
  • Taguri Masataka
    Department of Health Data Science, Tokyo Medical University
  • Toyoda Shigeru
    Department of Cardiovascular Medicine, Dokkyo Medical University

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Abstract

<p>Background: Because the penetration of transvenous lead extraction (TLE) for cardiac implantable electronic device (CIED) infection has not been investigated in Japan, we conducted a population-based, retrospective, descriptive study to evaluate regional disparities in the use of TLE for CIED infection and the potential undertreatment of CIED infection using a nationwide insurance claims database.</p><p>Methods and Results: Patients who underwent CIED implantation or generator exchange and TLE between April 2018 and March 2020 were identified. Moreover, the penetration ratio of TLE for CIED infection in each prefecture was estimated. CIED implantation and TLE were most prevalent in the age categories of 80–89 years (40.3%) and 80–89 years (36.9%), respectively. There was no correlation between the number of CIED implantations and that of TLE (rho=−0.087, 95% confidence interval −0.374 to 0.211, P=0.56). The median penetration ratio was 0.00 (interquartile range 0.00–1.29). Of the 47 prefectures, 6, comprising Okinawa, Miyagi, Okayama, Fukuoka, Tokyo, and Osaka, showed a penetration ratio ≥2.00.</p><p>Conclusions: Our study data indicated great regional disparities in the penetration of TLE and potential undertreatment of CIED infection in Japan. Additional measures are needed to address these issues.</p>

Journal

  • Circulation Journal

    Circulation Journal 87 (7), 1000-1006, 2023-06-23

    The Japanese Circulation Society

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