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

Guy Amit, Mahmoud Suleiman, Yuval Konstantino, David Luria, Mark Kazatsker, Israel Chetboun, Moti Haim, Natalie Gavrielov-Yusim, Ilan Goldenberg, Michael Glikson

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1175-1180
Number of pages6
JournalEuropace
Volume16
Issue number8
DOIs
StatePublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Cardiac resynchronization therapy
  • Implantable cardioverter-defibrillators
  • Outcomes
  • Registry
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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