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No gender differences in pacemaker selection in patients undergoing their first implantation.
J E Roeters Van Lennep1, A H Zwinderman, H W Roeters Van Lennep
1Department of Cardiology, Leiden University Medical Center, The Netherlands.
Pacing and Clinical Electrophysiology : PACE
|August 30, 2000
Summary
This study found no significant gender differences in pacemaker selection for first-time implantations in The Netherlands. Pacemaker choice appears to be based on patient age rather than sex.
Area of Science:
- Cardiology
- Medical Device Technology
- Health Disparities
Background:
- Previous research suggests potential gender disparities in the utilization of advanced pacemaker devices.
- These observed differences were not fully attributable to demographic or clinical factors.
Purpose of the Study:
- To investigate potential gender-related differences in pacemaker mode selection among patients undergoing their initial pacemaker implantation.
- To analyze pacemaker selection patterns across different age groups and cardiac conditions.
Main Methods:
- Analysis of a large cohort of 33,564 patients from The Netherlands who underwent their first pacemaker implantation between 1988 and 1997.
- Comparison of pacemaker mode selection between men and women across various diagnostic categories, including atrioventricular conduction disorders, bundle branch block, sick sinus syndrome, and chronic atrial fibrillation/flutter with bradycardia.
Main Results:
- No significant sex differences in pacemaker selection were found for patients with atrioventricular conduction disorders and bundle branch block.
- In older patients (≥85 years) with sick sinus syndrome, women received more atrial systems, while men received more dual-chamber pacemakers; however, the physiological vs. non-physiological distribution was similar.
- In the 75-85 age group with chronic atrial fibrillation/flutter and bradycardia, women received more dual-chamber pacemakers, and men received more single-chamber ventricular pacemakers, but the overall trend showed no major sex differences with increasing age.
Conclusions:
- The study indicates no substantial gender-based differences in the selection of pacemaker devices for first-time implantations.
- Pacemaker selection appears primarily influenced by patient age, suggesting a rational clinical decision-making process by physicians.
- Further research may be warranted to explore nuanced factors influencing device selection in specific patient subgroups.