Korean Circ J.  2019 Sep;49(9):841-852. 10.4070/kcj.2018.0444.

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

• Lee JH
• Lee SR
• Choi EK
• Jeong J
• Park HD
• You SJ
• Lee SS
• Oh S

• KMID: 2455790
• DOI: http://doi.org/10.4070/kcj.2018.0444

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.

Keyword

Artificial pacemaker; Implantable defibrillators; Epidemiology

MeSH Terms

Adult
Asian Continental Ancestry Group
Atrial Fibrillation
Cardiac Resynchronization Therapy
Comorbidity
Defibrillators, Implantable
Diabetes Mellitus
Epidemiology
Health Care Costs
Heart Failure
Humans
Hypertension
Korea
National Health Programs
Pacemaker, Artificial
Prevalence
Stroke

Figure

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  Figure 1 Temporal trends of new implantations (A), generator replacements (B), and annual new implantation rates (per 100,000) of cardiac implantable electronic devices. CRT = cardiac resynchronization therapy; ICD = implantable cardioverter defibrillators; PM = pacemakers.

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  Figure 2 Temporal trends of age specific implantation rates (per 100,000 subjects) of CIED. CIED = cardiac implantable electronic devices; CRT = cardiac resynchronization therapy; ICD = implantable cardioverter defibrillators; PM = pacemakers.

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  Figure 3 Temporal trends of the utilization of single chamber and dual chamber device in patients receiving new implantation of pacemaker (A) and implantable cardioverter defibrillator (B). ICD = implantable cardioverter defibrillators; PM = pacemakers.

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