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The status of pacemaker implantations in Japan
1Department of Surgery, Baylor College of Medicine, Houston, TX 77030.
Insights
Japan utilizes fewer implantable pacemakers compared to the US and Europe, with all devices being foreign-made. Local manufacturing is recommended to increase pacemaker use and affordability in Japan.
Area of Science:
- Biomedical Engineering
- Cardiology
- Medical Device Technology
Background:
- The clinical application of cardiac pacemakers has a history exceeding 40 years.
- Implantable pacemakers are vital for patient survival, with high utilization rates in the US and Europe (approx. 300 per million).
- Recent registry studies in Japan for 1989-1990 provide data on pacemaker utilization.
Purpose of the Study:
- To describe the results of pacemaker registry studies conducted in Japan for 1989 and 1990.
- To analyze the current utilization rates and manufacturing sources of implantable cardiac pacemakers in Japan.
- To identify factors contributing to the lower clinical application of pacemakers in Japan.
Main Methods:
- Analysis of data from pacemaker registry studies conducted by the Japanese Cardiac Pacing Society and the Japanese Society of Artificial Organs for 1989 and 1990.
- Comparison of pacemaker utilization rates in Japan with those in the United States and Europe.
- Examination of the origin of pacemakers used in Japanese clinical practice.
Main Results:
- Implantable cardiac pacemakers are utilized at a significantly lower rate in Japan (120 per million patients) compared to the US and Europe.
- All pacemaker implantations in Japan during the study period used foreign-manufactured devices.
- Despite advanced domestic electronic technology, no Japanese-made implantable pacemakers were utilized.
Conclusions:
- The high cost of imported pacemakers, potentially due to import duties, is a likely reason for their limited use in Japan.
- Local manufacturing of implantable cardiac pacemakers in Japan is strongly recommended.
- Manufacturing pacemakers domestically could increase utilization rates to levels comparable to the US and Europe.
Abstract:
It has been over 40 years since the initial clinical application of a cardiac pacemaker. Currently, approximately 300 per million patients in the United States and Europe are kept alive owing to the benefit of implantable pacemakers. Recently, the Japanese Cardiac Pacing Society and the Japanese Society of Artificial Organs performed pacemaker registry studies for 1989 and 1990. In this paper, results of this survey are described. Currently, implantable cardiac pacemakers are utilized only on the level of 120 per million patients in Japan. Surprisingly, all implantations were performed using foreign manufactured pacemakers. Despite the high level of electronic technologies available in Japan, no Japanese-made implantable cardiac pacemakers are utilized in Japan. One could speculate that a major reason for the low level of clinical application of cardiac pacemakers is that these devices are quite expensive because of the import duties imposed on them. It is necessary and strongly recommended that implantable cardiac pacemakers be manufactured in Japan in order for them to be utilized as fully as they are in the United States and Europe.