Amit G et al; Israeli Working Group on Pacing and Electrophysiology. Sex differences in implantable cardioverter-defibrillator implantation indications and outcomes: lessons from the Nationwide Israeli-ICD Registry. Europace. 2014 Aug;16(8):1175-80.

Europace. 2014 Aug;16(8):1175-80. doi: 10.1093/europace/euu015. Epub 2014 Feb 19.

Sex differences in implantable cardioverter-defibrillator implantation indications and outcomes: lessons from the Nationwide Israeli-ICD Registry.

Amit G(1), Suleiman M(2), Konstantino Y(3), Luria D(4), Kazatsker M(5), Chetboun I(6), Haim M(6), Gavrielov-Yusim N(7), Goldenberg I(7), Glikson M(4); Israeli Working Group on Pacing and Electrophysiology.

Author information:
(1)Cardiology Department, Soroka Medical Center, Beer-Sheva, Israel Division of Cardiology, Department of Medicine McMaster University, Hamilton General Hospital 237 Barton Street East, Hamilton, ON L8L 2X2, Canada gamitmd@gmail.com.
(2)Cardiology Department, Rambam Medical Center, Haifa, Israel.
(3)Cardiology Department, Soroka Medical Center, Beer-Sheva, Israel.
(4)Cardiology Department, Soroka Medical Center, Beer-Sheva, Israel Cardiology Department, Sheba Medical Center, Tel Hashomer, Israel.
(5)Cardiology Department, Hillel Yafe Hospital, Hadera, Israel.
(6)Cardiology Department, Meir Hospital, Kfar Saba, Israel.
(7)IACT-Neufeld Cardiac Research Institute, Tel Hashomer, Israel.

AIMS: Implantable cardioverter-defibrillators (ICDs) improve survival in certain high arrhythmic risk populations. However, there are sex differences regarding both the utilization and the benefit of these devices. Using a prospective national ICD registry, we aim to compare the indications for ICD implantation as well as outcomes in implanted women vs. men.

METHODS AND RESULTS: All subjects implanted with an ICD or cardiac resynchronization therapy with a defibrillator (CRTD) in Israel between July 2010 and February 2013 were included. A total of 3544 subjects constructed the baseline cohort, of whom 615 (17%) were women. Women had the same age (64 years) and rate of secondary prevention indication (26%) as men. However, women were more likely than men to have significant heart failure symptoms (52 vs. 45%), QRS> 120 ms (41 vs. 36%), and a higher rate of non-ischaemic cardiomyopathy (54 vs. 21%, all P values <0.05). Using multivariate analysis, women were more likely to undergo CRTD implantation (odds ratio = 1.8, P < 0.01). Follow-up data were available for 1518 subjects with a mean follow-up of 12 months. During follow-up, there were no significant differences among genders in the rate of any single or the combined outcomes of appropriate device therapies, heart failure admissions, or death. First-year re-intervention rate was double among women (5.6 vs. 3.0%, P< 0.01).

CONCLUSION: In real-world setting, women implanted with an ICD differ significantly from men in their baseline characteristics and in the use of CRTD devices. These, however, did not translate into outcome differences.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

PMID: 24554524  [PubMed - indexed for MEDLINE]

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