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Verification of atrial fibrillation treatment in Japan through cost-effectiveness analysis and construction of optimal treatment strategy

Research Project

Project/Area Number 20K23226
Research Category

Grant-in-Aid for Research Activity Start-up

Allocation TypeMulti-year Fund
Review Section 0908:Society medicine, nursing, and related fields
Research InstitutionEhime University

Principal Investigator

Kawakami Hiroshi  愛媛大学, 医学部附属病院, 助教 (10771579)

Project Period (FY) 2020-09-11 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords費用対効果分析 / 心房細動 / 睡眠時無呼吸症候群 / QOL / カテーテルアブレーション / 費用対効果 / 心不全 / 閉塞性睡眠時無呼吸症候群 / スクリーニング / 循環器疾患
Outline of Research at the Start

近年の心房細動(AF)治療は急速に発展しており、カテーテルアブレーションや新規抗凝固薬、左心耳閉鎖デバイスなど、治療の選択肢は大幅に広がった。しかしながら、それぞれの治療成績は一定ではないため、患者によって適切な治療法は異なっている。また、AFの新規治療は従来のものに比べて高額であるが、その費用に応じた効果については十分に検証されていない。そこで本研究では、本邦から報告されたAF治療に関する文献を体系的にレビューし、その結果を基にしてさまざまなAF患者を想定した費用対効果分析を行い、本邦における最も費用対効果の高いAF治療を模索する。

Outline of Final Research Achievements

With the aging of society in Japan, the number of patients with atrial fibrillation (AF) has been increasing every year. AF can lead to heart failure and stroke, which can cause bedridden, resulting in a significant impact on Japan's healthcare economy due to the associated medical costs. Therefore, in this study, we systematically reviewed literature related to AF treatment and conducted cost-effectiveness analyses for various AF patients based on the results, in order to verify the most cost-effective AF treatment in Japan. As a result of the study, it was revealed that screening and treatment intervention for sleep apnea in patients with AF is highly cost-effective.

Academic Significance and Societal Importance of the Research Achievements

心房細動治療において、睡眠時無呼吸症候群のスクリーニングおよび治療の重要性を明らかにした。心房細動患者において、睡眠時無呼吸症候群は再発リスクの一つである。積極的にスクリーニングを行い、適切な治療介入を行うことで、心房細動治療成績が向上し、最終的には費用対効果に優れた治療戦略となりうることを報告した。本邦の医療費抑制や医療の効率化に寄与する結果と考える。

Report

(4 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (19 results)

All 2023 2022 2021 2020

All Journal Article (7 results) (of which Peer Reviewed: 7 results,  Open Access: 4 results) Presentation (12 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Premature atrial contraction immediately after catheter ablation was associated with late recurrence of atrial fibrillation2023

    • Author(s)
      Fujisawa T, Kawakami H, Nagai T, Miyazaki S, Akazawa Y, Miyoshi T, Higaki A, Seike F, Higashi H, Nishimura K, Inoue K, Ikeda S, Yamaguchi O.
    • Journal Title

      Pacing Clin Electrophysiol .

      Volume: 46 Issue: 2 Pages: 152-160

    • DOI

      10.1111/pace.14648

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Evaluation of health utility in trial-based cost utility analyses for major cardiovascular disease: protocol for a systematic review2023

    • Author(s)
      Yasuhisa Nakao, Hiroshi Kawakami , Shigehiro Miyazaki, Makoto Saito, Yan Luo, Kazumichi Yamamoto, Osamu Yamaguchi
    • Journal Title

      BMJ Open

      Volume: 13 Issue: 5 Pages: e067045-e067045

    • DOI

      10.1136/bmjopen-2022-067045

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Atrial fibrillation arising from a silent superior vena cava.2022

    • Author(s)
      Fujisawa T, Nagai T, Kawakami H, Yamaguchi O.
    • Journal Title

      HeartRhythm Case Rep.

      Volume: 9 Issue: 3 Pages: 156-159

    • DOI

      10.1016/j.hrcr.2022.12.002

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Cost-Effectiveness of long-term tolvaptan administration for chronic heart failure treatment in Japan2022

    • Author(s)
      Nakao Yasuhisa、Kawakami Hiroshi、Saito Makoto、Inoue Katsuji、Ikeda Shuntaro、Yamaguchi Osamu
    • Journal Title

      Journal of Cardiology

      Volume: 79 Issue: 3 Pages: 408-416

    • DOI

      10.1016/j.jjcc.2021.10.026

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] The person has no left atrial appendage by nature: a rare anatomical cardiac condition2022

    • Author(s)
      Kawakami Hiroshi、Fujisawa Tomoki、Nagai Takayuki、Yamaguchi Osamu
    • Journal Title

      Journal of Interventional Cardiac Electrophysiology

      Volume: NA Issue: 3 Pages: 739-740

    • DOI

      10.1007/s10840-021-01107-7

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Persistence of left atrial abnormalities despite left atrial volume normalization after successful ablation of atrial fibrillation2021

    • Author(s)
      Kawakami Hiroshi、Inoue Katsuji、Nagai Takayuki、Fujii Akira、Sasaki Yasuhiro、Shikano Yukari、Sakuoka Namiko、Miyazaki Maki、Takasuka Yasunori、Ikeda Shuntaro、Yamaguchi Osamu
    • Journal Title

      Journal of Arrhythmia

      Volume: 37 Issue: 5 Pages: 1318-1329

    • DOI

      10.1002/joa3.12624

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Cost-Effectiveness of Obstructive Sleep Apnea Screening and Treatment Before Catheter Ablation for Symptomatic Atrial Fibrillation2020

    • Author(s)
      Kawakami Hiroshi、Saito Makoto、Kodera Satoshi、Fujii Akira、Nagai Takayuki、Uetani Teruyoshi、Tanno Sakurako、Oka Yasunori、Ikeda Shuntaro、Komuro Issei、Marwick Thomas H.、Yamaguchi Osamu
    • Journal Title

      Circulation Reports

      Volume: 2 Issue: 9 Pages: 507-516

    • DOI

      10.1253/circrep.CR-20-0074

    • NAID

      130007899912

    • ISSN
      2434-0790
    • Year and Date
      2020-09-10
    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 植込み翌日に右房へ脱落したリードレスペースメーカを経皮的に回収し得た1例2023

    • Author(s)
      平良百萌、川上大志、西村和久、菅野 司、小田真矢、橋本美和、浅木康志、赤澤祐介、三好徹、檜垣彰典、清家史靖、東 晴彦、永井啓行、山田文哉、井上勝次、池田俊太郎、山口 修
    • Organizer
      日本不整脈心電学会 第15回植込みデバイス関連冬季大会
    • Related Report
      2022 Annual Research Report
  • [Presentation] Cost-utility analysis of remote follow-up after pacemaker implantation for bradycardia in Japan2023

    • Author(s)
      Tomoki Fujisawa, Hiroshi Kawakami, Makoto Saito, Takayuki Nagai, Kazuhisa Nishimura, Katsuji Inoue, Shuntaro Ikeda, Osamu Yamaguchi
    • Organizer
      第87回日本循環器学会学術大会
    • Related Report
      2022 Annual Research Report
  • [Presentation] Association of Premature Atrial Contraction Just After Procedure with the Outcome of Atrial Fibrillation Ablation2022

    • Author(s)
      Tomoki Fujisawa, Hiroshi Kawakami, Takayuki Nagai, Shigehiro Miyazaki, Yusuke Akazawa, Toru Miyoshi, Haruhiko Higashi, Kazuhisa Nishimura, Katsuji Inoue, Shuntaro Ikeda, Osamu Yamaguchi.
    • Organizer
      第68回日本不整脈心電学会学術大会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 植込み型心臓デバイスの電池寿命予測精度の検証2022

    • Author(s)
      小田真矢、川上大志、浅木康志、橋本美和、平良百萌、藤澤友輝、永井啓行、西村和久、山田文哉、泉谷裕則、山口修
    • Organizer
      第68回日本不整脈心電学会学術大会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 遠隔モニタリング一元管理システム「ORFICE」導入による管理業務効率化の検証2022

    • Author(s)
      浅木 康志、川上 大志、平良百萌、小田 真矢、橋本 美和、山田 文哉、藤澤友輝、永井 啓行、山口 修
    • Organizer
      第2回日本不整脈心電学会中国・四国支部地方会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 左側開胸による心外膜アブレーションを行った難治性心室頻拍の1例2022

    • Author(s)
      藤澤友輝、川上大志、永井啓行、赤澤 祐介、三好 徹、檜垣 彰典、清家 史靖、東 晴彦、西村 和久、井上 勝次、池田 俊太郎、山口 修
    • Organizer
      日本不整脈心電学会 カテーテルアブレーション関連秋季大会2022
    • Related Report
      2022 Annual Research Report
  • [Presentation] Left Atrial Dysfunction Still Exists in Patients who Obtain Normal Left Atrial Volume After Successful Ablation of Atrial Fibrillation2021

    • Author(s)
      Kawakami H, Inoue K, Nagai T, Fujii A, Sasaki Y, Shikano Y, Sakuoka N, Miyazaki M, Takasuka Y, Ikeda S, Yamaguchi O.
    • Organizer
      ヨーロッパ心臓病学会
    • Related Report
      2021 Research-status Report
    • Int'l Joint Research
  • [Presentation] Cost-effectiveness of Obstructive Sleep Apnea Screening and Treatment Before Catheter Ablation for Symptomatic Atrial Fibrillation.2021

    • Author(s)
      Hiroshi Kawakami, Makoto Saito, Satoshi Kodera, Akira Fujii, Takayuki Nagai, Teruyoshi Uetani, Sakurako Tanno, Yasunori Oka, Shuntaro Ikeda, Issei Komuro, Thomas H. Marwick, Osamu Yamaguchi.
    • Organizer
      第67回日本不整脈心電学会学術大会
    • Related Report
      2021 Research-status Report
  • [Presentation] 起源の特定に心内エコーが有用であったCardiac crux由来の心室期外収縮の1例2021

    • Author(s)
      川上大志、永井啓行、藤澤友輝、小池翔太、宮崎慈大、赤澤祐介、三好徹、東晴彦、青野潤、西村和久、井上勝次、池田俊太郎、山口修
    • Organizer
      第32回カテーテルアブレーション関連 秋季大会
    • Related Report
      2021 Research-status Report
  • [Presentation] 先天性左心耳欠損を認めた心房細動の1例2021

    • Author(s)
      中西智紀、川上大志、藤澤友輝、永井啓行、小池翔太、宮崎慈大、赤澤祐介、三好徹、東晴彦、青野潤、西村和久、井上勝次、池田俊太郎、山口修
    • Organizer
      第119回日本循環器学会四国地方会
    • Related Report
      2021 Research-status Report
  • [Presentation] Cost-Effectiveness Analysis of the Long-Term Tolvaptan Strategy in Japanese Patients with Heart Failure2021

    • Author(s)
      Yasuhisa Nakao, Hiroshi Kawakami, Makoto Saito, Katsuji Inoue, Shuntaro Ikeda, Osamu Yamaguchi
    • Organizer
      第85回日本循環器学会学術集会
    • Related Report
      2020 Research-status Report
  • [Presentation] Cost-Effectiveness of Obstructive Sleep Apnea Screening and Treatment Before Catheter Ablation for Symptomatic Atrial Fibrillation2021

    • Author(s)
      Kawakami Hiroshi, Saito Makoto, Kodera Satoshi, Fujii Akira, Nagai Takayuki, Uetani Teruyoshi, Tanno Sakurako, Oka Yasunori, Ikeda Shuntaro, Komuro Issei, Marwick Thomas H., Yamaguchi Osamu
    • Organizer
      第67回日本不整脈心電学会学術大会
    • Related Report
      2020 Research-status Report

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Published: 2020-09-29   Modified: 2024-01-30  

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