Influence of gender on inducibility of ventricular arrhythmias in survivors of cardiac arrest with coronary artery disease

Vaitkus, Paul T.; Kindwall, K E; Miller, John M.; Marchlinski, Francis E.; Buxton, Alfred E.; Josephson, Mark E.

doi:10.1016/0002-9149(91)90020-l

Cited by 23 publications

(15 citation statements)

References 6 publications

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“…There was a significantly higher prevalence of a history of CHF in women compared to men in the randomized group. We also found that women were less likely to have inducible sustained ventricular tachyarrhythmias, which is similar to results of previous retrospective studies 16,17,19,20 …”

Section: Discussionsupporting

confidence: 91%

Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia Trial

Russo

Stamato

Lehmann

et al. 2004

Cardiovasc electrophysiol

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The outcome and benefit of EP-guided therapy in this trial did not appear to be influenced by gender. However, due to the small numbers of women in the trial, small differences in outcome may not be apparent. Plans for future primary prevention trials should include careful risk stratification of women who less often have inducible sustained ventricular arrhythmias and better left ventricular function despite more frequent heart failure.

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Section: Discussionsupporting

confidence: 91%

Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia Trial

Russo

Stamato

Lehmann

et al. 2004

Cardiovasc electrophysiol

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“…Among patients with coronary artery disease, VT or VF is less inducible in women despite similar ejection fractions, number of diseased coronary arteries and history of myocardial infarction. 50 With regard to outcome after prophylactic ICD implantation, ICD reduced mortality in men significantly (HR 0.67, 95 % CI 0.58-0.78, p<0.001) (see Figure 2), whereas in women the mortality reduction did not reach statistical significance (HR 0.78, 95 % CI 0.57-1.05, p=0.1) (see Figure 3). 45 In conclusion, available evidence suggests that the presence of severe left ventricular dysfunction may not reliably identify females at risk of sudden cardiac death, and prophylactic ICD therapy based only on left ventricular dysfunction might not be beneficial in this subgroup.…”

Section: Implantable Cardioverter Defibrillatormentioning

confidence: 96%

Outcomes in Women Undergoing Electrophysiological Procedures

Biase

Basile

Al‐Ahmad

2013

Arrhythmia &Amp; Electrophysiology Review

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The number of invasive electrophysiological procedures is steadily increasing in Western countries, as the age of the population increases and technologies advance. In recent years, gender-related differences in cardiac rhythm disorders have been increasingly appreciated, which can potentially have a great impact on the outcomes of invasive electrophysiological procedures. Among supraventricular arrhythmias, women have a higher incidence of atrioventricular nodal re-entrant tachycardia and a significantly lower incidence of atrioventricular re-entrant tachycardia compared with males, and present to ablation procedures later and after having failed more antiarrhythmic drugs. The results of catheter ablation of atrial fibrillation in women have been reported worse than in men. This finding is possibly due to a later referral of females to ablation procedures, who present older and with a higher incidence of long-standing persistent atrial fibrillation. With regard to cardiac device implantation procedures, a smaller survival benefit from prophylactic implantable cardioverter defibrillator (ICD) implantation has been shown in women, essentially due to gender-specific differences in the clinical course of patients with severe left ventricular dysfunction, with women dying predominantly from non-arrhythmic causes. On the other side, the clinical outcome of cardiac resynchronisation therapy seems to be more favourable in women, who experience a greater degree of reverse left ventricular remodelling and a striking decrease of heart failure events or mortality after biventricular pacing. This review will summarise the available evidence on gender-related differences in outcomes of invasive electrophysiological procedures.

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“…118 Why women are protected is not clear. 120 Among patients with CAD and implantable cardioverter defibrillation, women are less likely to experience VT/VF although this may be due to higher ejection fractions and less diabetes in women. 119 Differences in susceptibility to ventricular arrhythmia may also play a role.…”

Section: Ventricular Arrhythmias and Sudden Cardiac Death Ischemia-imentioning

confidence: 99%

Effect of Female Sex on Cardiac Arrhythmias

Gowd

Thompson

2012

Cardiology in Review

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We performed a systematic literature review to examine the effect of female sex on cardiac electrophysiology and arrhythmias. Women have faster resting heart rates yet longer QTc intervals. Women also have shorter PR and QRS intervals; these are presumed to be due to the small heart size of women and hormonal effects on ion channels. Women are two times more likely to experience atrioventricular nodal re-entry tachycardia than men. In contrast to atrioventricular nodal re-entry tachycardia, accessory-pathway-mediated atrial arrhythmias are less common in women, and women have more concealed and fewer manifest accessory pathways. Supraventricular tachycardia in women varies with the menstrual cycle and is more frequent in the luteal phase and inversely correlated with estrogen levels. Atrial fibrillation (AF) is less prevalent in women, but the absolute number of women with AF is higher because AF prevalence increases with age and women live longer. Also, complications of AF are greater in women. Women are generally less prone to ventricular arrhythmias, but they comprise a higher percentage of symptomatic subjects with congenital long QT syndrome and are more often affected by drugs that prolong the QT. Women are less prone to arrhythmias during pregnancy although they commonly complain of palpitations, which are sometimes related to the increase in heart rate during pregnancy. Clinicians should explore the relationship of arrhythmias to the menstrual cycle in female patients and should know that the menstrual cycle may affect the induction of arrhythmias during electrophysiological testing. Clinicians should also be aware that the arrhythmia and the result of clinical trials examining arrhythmia treatment may have different implications in women than in men.

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Influence of gender on inducibility of ventricular arrhythmias in survivors of cardiac arrest with coronary artery disease

Cited by 23 publications

References 6 publications

Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia Trial

Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia Trial

Outcomes in Women Undergoing Electrophysiological Procedures

Effect of Female Sex on Cardiac Arrhythmias

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