Differences between Korea and Japan in Physician Decision Making Regarding Permanent Pacemaker Implantation

作者：Jang Sung Won; Rho Robert W; Kim Tae Seok; Kim Sung Hwan; Shin Woo Seung; Kim Ji Hoon; Oh Yong Seog; Lee Man Young; Zen Eiwa; Rho Tai Ho^*

来源：Korean Circulation Journal, 2016, 46(5): 654-657.

DOI：10.4070/kcj.2016.46.5.654

• Pacemaker, artificial
• Sick sinus syndrome
• Atrioventricular block
• Physicians
• Guidelines

Background and Objectives: The number of permanent pacemakers (PPMs) implanted in patients in Japan and Korea differs significantly. We aimed to investigate the differences in decision making processes of implanting a PPM.
Materials and Methods: Our survey included 15 clinical case scenarios based on the 2008 AHA/ACC/HRS guidelines for device-basd therapy of cardiac rhythm abnormalities (class unspecified). Members of the Korean and Japanese Societies of Cardiology were asked to rate each scenario according to a 5-point scale and to indicate their decisions for or against implantation.
Results: Eighty-nine Korean physicians and 192 Japanese physicians replied to the questionnaire. For the case scenarios in which there was a class I indication for PPM implantation, the decision to implant a PPM did not differ significantly between the two physician groups. However, the Japanese physicians were significantly more likely than the Korean physicians to choose implantation in class IIa scenarios (48% vs. 37%, p<0.001), class IIb scenarios (40% vs. 19%, p<0.001), and class III scenarios (36% vs. 18%, p<0.001). These results did not change when the cases were categorized based on disease entity, such as sinus node dysfunction and conduction abnormality.
Conclusion: Korean physicians are less likely than Japanese physicians to favor a PPM implantation when considering a variety of clinical case scenarios, which probably contributes to the relatively small number of PPMs implanted in patients in Korea as compared with those in Japan.

• 出版日期2016-9