BACKGROUND: Regional variation in the use of percutaneous coronary intervention (PCI), especially when performed as an elective procedure, was observed in a previous study. The use of a developing technology, catheter ablation (CA), was compared between regions in Japan. METHODS AND RESULTS: The Diagnostic Procedure Combination data, which are publicly available, were used for the analysis. The number of CAs was summarized and the rates for CA and PCI were calculated based on the prefecture's population aged ≥40 years. A linear regression model was constructed to identify the factors associated with regional variation in the use of CA. The number of CAs performed per hospital consistently increased from 2009 to 2018. The mean rate of CA across Japan was 119 per 100 000 population aged ≥40 years in 2018. The highest CA rate was 166 per 100 000 and the lowest CA rate was 29 per 100 000 in 2018, while the highest and lowest PCI rates for angina per 100 000 were 361 and 88 in 2018, respectively. The significant factor associated with regional variation in the CA rate was the number of specialists. CONCLUSIONS: A wide regional variation was observed in the use of CA for patients with arrhythmia in Japan. Further research is needed to generate evidence of CA for decision-making as a treatment option and to appropriately deploy this health service regardless of where patients live.
BACKGROUND: Regional variation in the use of percutaneous coronary intervention (PCI), especially when performed as an elective procedure, was observed in a previous study. The use of a developing technology, catheter ablation (CA), was compared between regions in Japan. METHODS AND RESULTS: The Diagnostic Procedure Combination data, which are publicly available, were used for the analysis. The number of CAs was summarized and the rates for CA and PCI were calculated based on the prefecture's population aged ≥40 years. A linear regression model was constructed to identify the factors associated with regional variation in the use of CA. The number of CAs performed per hospital consistently increased from 2009 to 2018. The mean rate of CA across Japan was 119 per 100 000 population aged ≥40 years in 2018. The highest CA rate was 166 per 100 000 and the lowest CA rate was 29 per 100 000 in 2018, while the highest and lowest PCI rates for angina per 100 000 were 361 and 88 in 2018, respectively. The significant factor associated with regional variation in the CA rate was the number of specialists. CONCLUSIONS: A wide regional variation was observed in the use of CA for patients with arrhythmia in Japan. Further research is needed to generate evidence of CA for decision-making as a treatment option and to appropriately deploy this health service regardless of where patients live.
Authors: Tanush Gupta; Ankur Kalra; Dhaval Kolte; Sahil Khera; Pedro A Villablanca; Kashish Goel; Anna E Bortnick; Wilbert S Aronow; Julio A Panza; Neal S Kleiman; J Dawn Abbott; David P Slovut; Cynthia C Taub; Gregg C Fonarow; Michael J Reardon; Charanjit S Rihal; Mario J Garcia; Deepak L Bhatt Journal: Am J Cardiol Date: 2017-08-10 Impact factor: 2.778
Authors: Oussama M Wazni; Nassir F Marrouche; David O Martin; Atul Verma; Mandeep Bhargava; Walid Saliba; Dianna Bash; Robert Schweikert; Johannes Brachmann; Jens Gunther; Klaus Gutleben; Ennio Pisano; Dominico Potenza; Raffaele Fanelli; Antonio Raviele; Sakis Themistoclakis; Antonio Rossillo; Aldo Bonso; Andrea Natale Journal: JAMA Date: 2005-06-01 Impact factor: 56.272
Authors: G T O'Connor; H B Quinton; N D Traven; L D Ramunno; T A Dodds; T A Marciniak; J E Wennberg Journal: JAMA Date: 1999-02-17 Impact factor: 56.272
Authors: Carlos A Morillo; Atul Verma; Stuart J Connolly; Karl H Kuck; Girish M Nair; Jean Champagne; Laurence D Sterns; Heather Beresh; Jeffrey S Healey; Andrea Natale Journal: JAMA Date: 2014-02-19 Impact factor: 56.272