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Temporal Trends of Cardiac Implantable Electronic Device Implantations: a Nationwide Population-based Study

Korean Circulation Journal 2019년 49권 9호 p.841 ~ 852
이지현 ( Lee Ji-Hyun ) - Seoul National University Bundang Hospital Department of Cardiology

 ( Lee So-Ryoung ) - Seoul National University Hospital Department of Internal Medicine
 ( Choi Eue-Keun ) - Seoul National University Hospital Department of Internal Medicine
 ( Jeong Jae-Han ) - Medtronic Korea Ltd.
 ( Park Hyung-Deuk ) - Medtronic Korea Ltd.
 ( You So-Jeong ) - Medtronic Korea Ltd.
 ( Lee Sang-Soo ) - Medtronic Korea Ltd.
 ( Oh Se-Il ) - Seoul National University Hospital Department of Internal Medicine
 ( Lee So-Ryoung ) - Seoul National University Hospital Department of Internal Medicine
 ( Choi Eue-Keun ) - Seoul National University Hospital Department of Internal Medicine
 ( Jeong Jae-Han ) - Medtronic Korea Ltd.
 ( Park Hyung-Deuk ) - Medtronic Korea Ltd.
 ( You So-Jeong ) - Medtronic Korea Ltd.
 ( Lee Sang-Soo ) - Medtronic Korea Ltd.
 ( Oh Se-Il ) - Seoul National University Hospital Department of Internal Medicine

Abstract


Background and Objectives: Implantation of cardiac implantable electronic devices (CIED), including permanent pacemakers (PM), implantable cardioverter-defibrillators (ICD), and cardiac resynchronization therapy (CRT) devices, has increased significantly over the past several years. However, limited data exists regarding temporal trends of CIED implantations in Asian population. This study aimed to investigate temporal trends of CIED treatment in Korea.

Methods: Using the National Health Insurance Service database of the entire Korean adult population, temporal trends of CIED procedures between 2009 and 2016 were evaluated. Additionally, temporal changes in the prevalence of patients’ comorbidities were evaluated.

Results: A total of 35,421 CIED procedures (new implantations: 27,771, replacements: 7,650) were performed during the study period. The mean age of new CIED recipients and the prevalence of comorbidities, including hypertension, diabetes mellitus, heart failure, stroke, and atrial fibrillation, increased substantially with time. Compared to 2009, the number of new implantations of PM, ICD, and CRT devices increased by 2.0 (1,977 to 3,910), 3.6 (230 to 822), and 4.9 (44 to 217) times in 2016, respectively. The annual new implantation rate of CIED also increased accordingly (5.1 to 9.3 for PM, 0.6 to 1.9 for ICD, and 0.1 to 0.5 for CRT devices, per 100,000 persons).

Conclusions: The number of CIED implantation increased substantially from 2009 to 2016 in Korea. Also, the patients with CIED have been changed to be older and have more comorbidities. Therefore, the burden of health care cost in patients with CIED would be expected to increase in the future.

키워드

Artificial pacemaker; Implantable defibrillators; Epidemiology
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