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.