Since June, 2007 I have served as President of the Japanese Heart Rhythm Society (JHRS). As you may know, in October 2005 the Japanese Society of Cardiac Pacing and Electrophysiology became a non-profit organization and was renamed JHRS. JHRS has played a central role in offering opportunities to physicians and co-medical personnel engaged in clinical work, research, and education related to arrhythmia. However, another important purpose of our society is to serve the general public. To achieve that goal, I think it is important for JHRS to publicize our activities in as much detail as possible. The following are some of the more significant ongoing activities of JHRS.

1) Establishment of a program to certify arrhythmia specialists
The purpose of the program to certify arrhythmia specialists is to increase the level of physicians engaged in the treatment of arrhythmias in order to standardize care, prevent complications and malpractice, and provide patients with criteria for selecting medical institutions and physicians. Preparing such a program will require that we assess the current level of basic knowledge concerning arrhythmia and the level of clinical treatment for this condition. We are currently working on the basic structure of the program. Support by the Japanese Society of Electrocardiology and Japanese Heart Failure Society will be essential for establishing this program.

2) Request for health insurance reimbursement revision for certain arrhythmia-related conditions
We will request revision of the national health insurance reimbursement assigned to pacemaker and ICD implant procedures during the next review because the current reimbursement amounts published in the last announcement in April 2006 were too low and did not reflect reality. We are currently collaborating with two insurance unions regarding this matter.

3) Enhancement of International Cooperation Committee activities
International activities of arrhythmia-related medical societies have increased on a yearly basis. The Asian Pacific AF Symposium (APAFS), which started in 2005, held its second conference in Tokyo in November, 2006. The third conference was held in Taiwan in October, 2007. In addition, the Asian Heart Rhythm Society (Asia Pacific Heart Rhythm Society - APHRS, 2008/07/07) is being organized. JHRS plans to send a several board members to participate in the preparation, and we are doing our best to expand activities in Asia as well as in the US and Europe. The 13th International Cardiac Pacing and Electrophysiology Symposium (ICPES) was held in Rome, Italy in December 2007. Several presentations were made by investigators from Japan. The conference is held every four year, and the 14th symposium is scheduled for Athens, Greece, in 2011.

4) ICD-CRT Joint Seminar
As cardiac resynchronization therapy (CRT) has become increasingly popular as a means of treating severe heart failure, ICD-CRT training has grown in importance. We held a joint ICD and CRT training seminar at the 21st Annual Meeting of the JHRS in July 2006, expanding the training seminar which was limited to ICD at the previous Meeting. In cooperating with the Japanese Heart Rhythm Society and the Japanese Heart Failure Society, we now offer the joint seminar twice a year during the Scientific Conference and Annual Meeting of the societies.

5�jOpen Conference on Catheter Ablation Therapy
The 19th Fall Conference on Catheter Ablation was held in Aomori city for three days starting on October 25th, 2007. As more than ten years have passed since catheter ablation began to be clinically applied, the number of clinical cases has increased every year. I believe it is necessary to accurately assess the current status of this treatment in order to encourage its continued growth. Therefore we will be requesting medical institutions where it is performed to register their cases. Once sufficient registration data are gathered, we can expect benefits, including an increase in the rate of successful treatment, prevention of complications and drafting of guidelines.

6) ICD and CRT-D case registration program
The number of cases of CRT-D treatment in which a CRT pacemaker is used to treat patients with severe heart failure and the number of cases in which ICDs are used to treat patients with life-threatening arrhythmias have been increasing, and it will be necessary to determine the current status of these treatments in order to increase the success rate and establish indications suitable for the situation in Japan, just as with catheter ablation therapy. We have therefore requested ICD and CRT-D case registration, and having been steadily gathering data with the cooperation of the relevant institutions.

7) Certification program for cardiac device representatives (CDRs)
As implantable life-supporting devices, such as pacemakers and ICDs, have come into increasingly widespread use, medical safety has become an important issue. The Fair Trade Association of the Medical Device Industry has set guidelines regarding technical assistance services by professionals employed by the industry, and they went into effect on April 1, 2008. Cooperation by the medical representatives in the industry is essential during medical treatment in order to ensure safety and improve the results. For this reason I am convinced that it is important to improve the competence level of CDRs. The CDR certification program will improve the quality of medical representatives in industry who provide information regarding pacemakers and ICDs.
The JHRS is actively involved in preparations to establish the certification program.