Nationwide Lifespan Trends in Cardiac Implantable Electronic Device Strategies in Japan: Age‐Dependent Changes in Transvenous and Epicardial Systems

Figures

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  FIGURE 1. Number of claims for CIED implantation by age group (years) for pacemakers with transvenous leads (A), pacemakers with epicardial leads (B), and leadless pacemakers (C), ICDs with transvenous leads (D), S‐ICDs (E), CRT with transvenous leads (F) and CRTDs with transvenous leads (G). CIED, cardiac implantable electronic device; CRT, cardiac resynchronization therapy; CRTD, cardiac resynchronization therapy defibrillator; FY, fiscal year; ICD, implantable cardioverter‐defibrillator; S‐ICD, subcutaneous ICD.

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  FIGURE 2. Trends in procedure rates per 100 000 population in Japan for transvenous CIEDs, leadless PMs and S‐ICDs (A), and for epicardial CIEDs (B). CIED, cardiac implantable electronic device; CRT, cardiac resynchronization therapy; CRTD, cardiac resynchronization therapy defibrillator; Epi, epicardial; FY, fiscal year; ICD, implantable cardioverter‐defibrillator; PM, pacemaker; S‐ICD, subcutaneous ICD; TV, transvenous.

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  FIGURE 3. Trends in age‐specific procedure rates per 100 000 population in Japan for pacemakers with transvenous leads (A), pacemakers with epicardial leads (B), leadless pacemakers (C), ICDs with transvenous leads (D), S‐ICDs (E), CRT with transvenous leads (F), and CRTDs with transvenous leads (G). CRT, cardiac resynchronization therapy; CRTD, cardiac resynchronization therapy defibrillator; FY, fiscal year; ICD, implantable cardioverter‐defibrillator; S‐ICD, subcutaneous ICD.

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  FIGURE 4. Trends in claims for epicardial lead use in Japan during fiscal years (FY) 2016–2023 (3). (A) Total number of implantations. (B) Number of implantations by age group (years). (C) Trends in age‐specific implantation rates per 100 000 population.

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  FIGURE 5. Data from the Japan Arrhythmia Device Industry Association (JADIA) [4] during fiscal years (FY) 2021 to 2023. (A) The proportion of implantation sites of epicardial leads among the total number of epicardial leads. (B) The proportion of the number of epicardial leads used per patient among all patients with epicardial leads. (C) The proportion of CIED types connected to epicardial leads among the total number of patients with epicardial leads. (D–G) show the proportion of the pediatric patients by age group (years) among the total number of new CIED implantations: PM (D), ICD (E), CRT (F), and CRTD (G). The data in (D–G) include all CIEDs with both transvenous and epicardial leads. “Total” represents data for patients aged 0–19 years. Blue and orange represent data from Medtronic Japan Co. Ltd. and Abbott Medical Japan LLC, respectively. CIED, cardiac implantable electronic device; CRT, cardiac resynchronization therapy; CRTD, cardiac resynchronization therapy defibrillator; FY, fiscal year; ICD, implantable cardioverter‐defibrillator; PM, pacemaker.