[Permanent cardiac pacing in women--light and shadow]

Permanent cardiac pacing has survived a sharp increase in quality improvement and frequency of usage. Nowadays particular aspects of this method of treatment are being considered. In this paper distinctiveness of women population treated by permanent pacing is discussed. Indications for heart pacing in women appear at a later age than in men. Moreover, women remain longer in follow-up, therefore their prognosis is better. The most serious late pacing complications, i.e., infections are less frequent in women. However, implantations procedures seem to be more difficult in female gender, most probably due to a smaller body size, especially of afferent veins. This leads to a higher periprocedural complication rate and refers especially to endocardial lead implantation, which in women is connected with double risk of pneumothorax. Late complications of permanent pacing are effectively treated by transvenous lead extraction. Female gender has been demonstrated as an independent risk factor of extraction failure. It seems that reasonable qualification for pacemaker implantations and leaving the procedures in the hands of experienced operators will strengthen the "light side" and limit the "dark side" of this therapy in women.