{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:19:45Z","timestamp":1788239985327,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nationwide epidemiological studies of cardiac implantable electronic devices (CIEDs) encompassing multiple device types and strategies remain limited in Japan, particularly regarding epicardial lead use and pediatric populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed the first nationwide analysis of CIED implantation trends using the National Database of Health Insurance Claims, including transvenous (TV)\/epicardial (Epi) systems for pacemakers, implantable cardioverter\u2010defibrillators (ICDs), cardiac resynchronization therapy (CRT), and CRT\u2010defibrillators (CRTDs), as well as leadless pacemakers, subcutaneous ICDs (S\u2010ICDs), and epicardial lead use. Epicardial lead and pediatric characteristics were supplemented using industry data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In fiscal year 2023, implantation rates per 100\u2009000 population were 29.69 for TV\u2010pacemakers, 7.06 for leadless pacemakers, 2.42 for TV\u2010ICDs, 0.889 for S\u2010ICDs, 1.20 for TV\u2010CRT, and 1.69 for TV\u2010CRTDs. Rates for epicardial systems were lower, at 0.173 for Epi\u2010pacemakers, 0\u20130.007 for Epi\u2010ICDs, 0.024 for Epi\u2010CRT, and 0.027 for Epi\u2010CRTDs, while epicardial lead use was 0.545. S\u2010ICD use increased across age groups, whereas TV\u2010ICD implantation declined (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Implantation of TV and leadless pacemakers, TV\u2010CRT, and TV\u2010CRTDs increased over time (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Epicardial lead use showed a bimodal age distribution, peaking in pediatric and elderly populations, and declined in older adults while remaining stable in children and adults aged 20\u201349\u2009years (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Pediatric CIED volumes were low, with several ICD, CRT, and CRTD procedures annually.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CIED strategies in Japan demonstrate age\u2010dependent variation. Epicardial systems remain indispensable in pediatric and congenital heart disease care, whereas alternative technologies are increasingly adopted in older adult populations, reflecting evolving lifespan\u2010related device strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70408","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:04:17Z","timestamp":1788239057000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide Lifespan Trends in Cardiac Implantable Electronic Device Strategies in Japan: Age\u2010Dependent Changes in Transvenous and Epicardial Systems"],"prefix":"10.1002","volume":"42","author":[{"given":"Aya","family":"Miyazaki","sequence":"first","affiliation":[{"name":"CIEDs Working Group of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Department of Adult Congenital Heart Disease Seirei Hamamatsu General Hospital  Hamamatsu Japan"},{"name":"Department of Pediatric Cardiology Seirei Hamamatsu General Hospital  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaku","family":"Izumi","sequence":"additional","affiliation":[{"name":"CIEDs Working Group of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Department of Pediatrics Hokkaido University Graduate School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Fujita","sequence":"additional","affiliation":[{"name":"CIEDs Working Group of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Department of Pediatrics Toyama Prefectural Central Hospital  Toyama Japan"},{"name":"Board Member of Japanese Society of Pediatric Electrocardiology  Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsugutoshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"CIEDs Working Group of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Board Member of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Departmemt of Pediatric Cardiology and Electrophysiology Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Board Member of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Department of Pediatrics Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Department of Electrophysiology Shizuoka Children's Hospital  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Toyohara","sequence":"additional","affiliation":[{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Department of Pediatric Cardiology and Adult Congenital Heart Disease Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunobu","family":"Hayabuchi","sequence":"additional","affiliation":[{"name":"Board Member of Japanese Society of Pediatric Electrocardiology  Japan"},{"name":"Department of Pediatrics Tokushima University Hospital  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Takagi","sequence":"additional","affiliation":[{"name":"Cardiac Implantable Electronic Device Committee of Japanese Heart Rhythm Society  Japan"},{"name":"Department of Medicine II Kansai Medical University Moriguchi  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_13_2_1","article-title":"The Present Status of CRT Therapy in Japan From the Database of JCDTR","volume":"19","author":"New Japan Cardiac Device Treatment Registry (New JCDTR)","journal-title":"Journal of Cardiac Failure"},{"key":"e_1_2_13_3_1","unstructured":"Japanese Registry of All Cardiac and Vascular Diseases accessed March 24 2026 https:\/\/wwwj\u2010circorjp\/jittai_chosa\/."},{"key":"e_1_2_13_4_1","article-title":"NDB Open Data Japan","volume":"15","author":"Ministry of Health, Labour and Welfare","journal-title":"Scientific Reports"},{"key":"e_1_2_13_5_1","unstructured":"Japan Arrhythmia Device Industry Association (JADIA) https:\/\/wwwjadiaorjp\/medical\/crt\u2010dhtml."},{"issue":"2","key":"e_1_2_13_6_1","first-page":"135","article-title":"Electromagnetic Interference From a Tablet Inducing Magnet Response in Abdominal Cardiac Implantable Electronic Devices: A Study From Japan","volume":"9","author":"Fujita S.","year":"2025","journal-title":"Journal of Pediatric Cardiology and Cardiac Surgery"},{"key":"e_1_2_13_7_1","unstructured":"\u201cPopulation Estimates Obtained From the Statistics Bureau of Japan Website \u201d accessed March 15 2026 https:\/\/wwwstatgojp\/english\/data\/jinsui\/2html."},{"issue":"9","key":"e_1_2_13_8_1","first-page":"884","article-title":"Current Situation of Pediatric Cardiac Implantable Electronic Devices","volume":"23","author":"Miyazaki A.","year":"2019","journal-title":"Heart 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