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[Cardiac arrhythmias in women]
1Service de Cardiologie, Université de Liège.
Insights
Gender significantly impacts cardiac arrhythmia prevalence and risk. Women face higher risks for certain arrhythmias like atrial fibrillation and long QT syndrome, while men experience more sudden cardiac death, though women are susceptible without structural heart disease.
Area of Science:
- Cardiology
- Electrophysiology
- Gender Medicine
Context:
- Cardiac arrhythmias exhibit distinct gender-specific epidemiological patterns.
- Understanding these differences is crucial for targeted prevention and treatment strategies.
- Existing research highlights variations in arrhythmia occurrence and associated risks between men and women.
Purpose:
- To delineate the gender-specific frequencies and clinical implications of various cardiac arrhythmias.
- To identify unique risk factors for arrhythmias and sudden cardiac death in women.
- To address the challenges in managing arrhythmias during pregnancy.
Summary:
- Atrial fibrillation is more prevalent in men, often linked to coronary heart disease, while in women, it frequently complicates heart failure or valvular disease, posing a higher stroke risk.
- Symptomatic supraventricular tachycardia and long QT syndrome are more common in women, who are also prone to torsades de pointes from potassium channel-blocking drugs.
- Sudden cardiac death is more frequent in men, but women without structural heart disease are disproportionately affected, with potential risk factors including nulliparity, smoking, and alcohol use.
Impact:
- Provides critical insights into gender-based cardiovascular health disparities.
- Informs clinical practice regarding risk stratification and therapeutic approaches for arrhythmias in men and women.
- Highlights the need for further research into sex-specific mechanisms and management of cardiac arrhythmias, particularly in pregnant individuals.
Abstract:
There exist gender differences in the frequency of the various forms of cardiac arrhythmias. Atrial fibrillation is more common in man in whom it is often a complication of coronary heart disease. Numerous elderly women however present with this rhythm disorder which is often a complication of congestive heart failure or valvular heart disease. Atrial fibrillation carries a high risk of cerebro-vascular embolic accident in female. Symptomatic supraventricular tachycardia and the long QT syndrome, inherited or acquired, are more frequent among women. The latter are also particularly susceptible to develop torsade de pointe as a consequence of therapy with drugs interfering with the potassium ion channels. Sudden cardiac death is more frequent in men than in women even when the latter suffer from coronary heart disease. Sudden cardiac death without structural heart disease is however more frequently seen in women. Nulliparity, tobacco use and alcoholism might be specific risk factors for sudden cardiac death in female. Cardiac arrhythmias may be seen during pregnancy. New onset or aggravated supraventricular tachycardia may be encountered during that period. Ventricular tachycardia in the absence of structural heart disease may also be seen during pregnancy. The treatment of cardiac arrhythmias in pregnant woman remains a challenge for the practising cardiologist.