Arrhythmias in Women

Abstract

There are important gender differences in cardiac electrophysiology that affect the epidemiology, presentation, and prognosis of various arrhythmias. Women have been noted to have higher resting heart rates compared to men. They also have a longer QT interval, which puts them at an increased risk for drug-induced torsades de pointes. Women with atrial fibrillation are at a higher risk of stroke, and they are less likely to receive anticoagulation and ablation procedures compared to men. Women have a lower risk of sudden cardiac death and are less likely to have known coronary artery disease at the time of an event compared to men. Both men and women have been shown to derive an equal survival benefit from implantable cardioverter defibrillators and cardiac resynchronization therapy, although these devices are significantly underutilized in women. Women also appear to have a better response to cardiac resynchronization therapy in terms of reduced numbers of hospitalizations and more robust reverse ventricular remodeling. Further studies are required to elucidate the underlying pathophysiology of these sex differences in cardiac arrhythmias. IntroductionSex differences in cardiac electrophysiology affect the epidemiology, presentation, and prognosis of various arrhythmias. These sex differences can have important clinical and therapeutic implications. Although the exact reason for these differences is not known, the potential mechanisms include differences in cardiac size, structure, and the different ways in which hormones, drugs, and electrolytes affect cardiac ion channels in men and women. The purpose of this review is to provide a synopsis of the important gender differences with respect to arrhythmias and to summarize updates from recent studies.

Sex differences in cardiomyopathies

“…Various studies have demonstrated marked differences between males and females in ischaemic heart disease, in terms of risk factors, aetiology, disease manifestation, diagnostic modalities, the use and effectiveness of various therapies, and prognoses . Likewise, several studies have revealed sex differences in heart failure and cardiac arrhythmias . This has led to worldwide research and educational initiatives on the specific characteristics of cardiovascular disease in women …”

“…2 -4 Likewise, several studies have revealed sex differences in heart failure 5 and cardiac arrhythmias. 6 This has led to worldwide research and educational initiatives on the specific characteristics of cardiovascular disease in women. 7 -9 In 2008, the Working Group of the European Society of Cardiology published a position statement on the classification of cardiomyopathies.…”

Evaluation of the Effect of Pulmonary Vein Isolation Treatment With Left Atrial Catheter Ablation Method on Atrial Conduction Times in Patients With Paroxysmal Atrial Fibrillation

“…Sex differences may affect diagnostic and therapeutic interventions in a wide variety of medical conditions including cardiac arrhythmias [32]. In our study, when atrial conduction times were compared before and after RF ablation according to sexes; no signi cant difference was observed between the two groups in male patients, while there were signi cant differences in all parameters except for intra-atrial conduction delay in female patients.…”

Sudden cardiac death – what do we know and how do we prevent it?

“…At the present stage of studies, in the prevention of SCD in females, criteria are applied which are currently the same for males, although the benefits in the group of females have not been sufficiently documented [27]. The precondition for undertaking a decision concerning ICD implantation is that the patients qualified for the procedure had the chance to live for at least one year in good general state [2].…”