Differences between Korea and Japan in Physician Decision Making Regarding Permanent Pacemaker Implantation.
10.4070/kcj.2016.46.5.654
- Author:
Sung Won JANG
1
;
Robert W RHO
;
Tae Seok KIM
;
Sung Hwan KIM
;
Woo Seung SHIN
;
Ji Hoon KIM
;
Yong Seog OH
;
Man Young LEE
;
Eiwa ZEN
;
Tai Ho RHO
Author Information
1. The Catholic University of Korea, Seoul, Korea. Tairho@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Pacemaker, artificial;
Sick sinus syndrome;
Atrioventricular block;
Physicians;
Guidelines
- MeSH:
Asian Continental Ancestry Group;
Atrioventricular Block;
Cardiology;
Decision Making*;
Humans;
Japan*;
Korea*;
Pacemaker, Artificial;
Sick Sinus Syndrome
- From:Korean Circulation Journal
2016;46(5):654-657
- CountryRepublic of Korea
- Language:English
-
Abstract:
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-based 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.
