Survival and heart failure hospitalization in patients with cardiac resynchronization therapy with or without a defibrillator for primary prevention in Japan ― Analysis of the Japan cardiac device treatment registry database

Members of the Implantable Cardioverter-Defibrillator (ICD) Committee of the Japanese Heart Rhythm Society

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Background: Randomized control trials comparing the effectiveness of cardiac resynchronization therapy devices, with (CRT-D) or without (CRT-P) a defibrillator, are scarce in heart failure patients with no prior sustained ventricular tachyarrhythmias. Methods and Results: The Japan Cardiac Device Treatment Registry (JCDTR) has data for 2714 CRT-D and 555 CRT-P recipients for primary prevention with an implantation date between January 2011 and August 2015. Of these patients, follow-up data were available for 717. Over the mean follow-up period of 21 months, Kaplan-Meier curves of survival free of combined events for all-cause death or heart failure hospitalization (whichever came first) diverged between the CRT-D (n=620) and CRT-P (n=97) groups with a rate of 22% vs. 42%, respectively, at 24 months (P=0.0011). However, this apparent benefit of CRT-D over CRT-P was no longer significant after adjustment for covariates. With regard to mortality, including heart failure death or sudden cardiac death, there was no significant difference between the 2 groups. Conclusions: In patients without sustained ventricular tachyarrhythmias enrolled in the JCDTR, there was no significant difference in mortality between the CRT-D and CRT-P groups, despite a lower trend in CRT-D recipients. This study was limited by large clinical and demographic differences between the 2 groups.

Original languageEnglish
Pages (from-to)1798-1806
Number of pages9
JournalCirculation Journal
Issue number12
Publication statusPublished - Jan 1 2017



  • Cardiac resynchronization therapy (CRT)
  • CRT defibrillator (CRT-D)
  • CRT pacemaker (CRT-P)
  • Primary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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