Abstract 9706: Sex Differences in Symptoms During Arrhythmias

Abstract

Introduction: Prior studies have reported sex differences in symptoms and quality of life in patients (pts) with atrial fibrillation (AF). It is currently unclear if this is also true for other arrhythmias or if symptoms occurring at the time of arrhythmia recordings differ by sex. Hypothesis: We hypothesized that women may be more symptomatic than men during atrial and ventricular arrhythmias and that differences may be associated with differences in heart rate (HR). Methods: We examined 27,203 pts (58% women) with up to 30-day ECGs recorded using the PocketECG (MediLynx), which transmits a 3-lead ambulatory ECG and uses an algorithm based on rhythm and morphology. VT and SVT were defined as 3 or more beats, and AV block included 2nd- or 3rd-degree block. A sustained arrhythmia was ≥30s. The rhythm occurring 30 s prior to symptoms was analyzed. Chi2 tests were used to compare women to men. Results: Men were older than women (68.9 ± 13.9 vs 67.7 ±15.6, 95% CI of the difference: [-1.55; -0.84]). Mean HR in SR was faster in women than in men (73.1 ± 10.3 vs. 70.2 ± 10.3 bpm, [2.64; 3.16]). Women were more likely to have SVT (76 vs. 74%) and less likely to have AF (15% vs. 21%), VT (23% vs. 41%), PVCs (45% vs. 61%), PACs (55% vs. 57%) or AV block (21% vs. 28%). Women were more likely than men to report symptoms (66.4% vs. 55.6%, p<0.001), including greater frequency of palpitations, chest discomfort, and shortness of breath (p<0.001 for all). (Figure 1) Women were more likely to report symptoms during PACs and SVT while men were more likely to report symptoms during AF (p <0.001 for all). Mean HR in AF is faster in women (106.5 ± 26.6 vs. 98.7 ± 27.4, 95% CI: [6.29 ; 9.36]). (Figure 2) Conclusions: Symptoms experienced during arrhythmias differ by sex. Reasons for these differences are currently unclear but could be related to ventricular function, underlying heart disease or medications, and are not clearly related to HR. Further study is needed to help identify reasons for differences in symptoms.