Sex-Specific Ventricular Arrhythmias and Mortality in Cardiac Resynchronization Therapy Recipients
Aurelio Quesada1, Francisco Arteaga2, Rafael Romero-Villafranca3
1Arrhythmia Unit, Cardiology Service, General University Hospital Consortium of Valencia, Valencia, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.
Insights
Women receiving cardiac resynchronization therapy defibrillators (CRT-D) experience fewer ventricular arrhythmias than men. Mortality rates were similar between sexes, indicating comparable long-term outcomes in CRT-D recipients.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Limited research exists on sex-specific benefits of cardiac resynchronization therapy (CRT).
- Data on sex differences in ventricular tachyarrhythmias among CRT-D recipients are scarce.
Purpose of the Study:
- To investigate sex-related differences in ventricular arrhythmia incidence and mortality in patients with CRT-D.
- To evaluate the impact of sex on outcomes following CRT-D implantation.
Main Methods:
- A multicenter retrospective study analyzed 460 patients (105 female, 355 male) from the UMBRELLA national registry.
- Patients with CRT-D were followed via remote monitoring for a median of 2.2 years.
- Analysis focused on sex differences in treated ventricular arrhythmias and mortality, particularly in primary prevention patients.
Main Results:
- Women presented with worse baseline functional class but had less ischemic heart disease.
- Female sex was an independent predictor of lower ventricular arrhythmia incidence (HR: 0.40; 95% CI: 0.19-0.86).
- All-cause mortality was lower in women (2.9%) compared to men (5.6%), though not statistically significant (p=0.25).
Conclusions:
- Women with left bundle branch block receiving CRT have a reduced rate of ventricular tachyarrhythmias compared to men.
- All-cause mortality appears similar between female and male CRT-D recipients.
Objectives:
The study goal was to examine whether there are sex-related differences in the incidence of ventricular arrhythmias and mortality in CRT-defibrillator (CRT-D) recipients.
Background:
Few studies have evaluated sex-related benefits of cardiac resynchronization therapy (CRT). Moreover, data on sex-related differences in the occurrence of ventricular tachyarrhythmias in this population are limited.
Methods:
A multicenter retrospective study was conducted in 460 patients (355 male subjects and 105 female subjects) from the UMBRELLA (Incidence of Arrhythmia in Spanish Population With a Medtronic Implantable Cardiac Defibrillator Implant) national registry. Patients were followed up through remote monitoring after the first implantation of a CRT-D during a median follow-up of 2.2 ± 1.0 years. Sex differences were analyzed in terms of ventricular arrhythmia-treated incidence and death during the follow-up period, with a particular focus on primary prevention patients.
Results:
Baseline New York Heart Association functional class was worse in women compared with that in men (67.0% of women in New York Heart Association functional class III vs. 49.7% of men; p = 0.003), whereas women had less ischemic cardiac disease (20.8% vs. 41.7%; p < 0.001). Female sex was an independent predictor of ventricular arrhythmias (hazard ratio: 0.40; 95% confidence interval: 0.19 to 0.86; p = 0.020), as well as left ventricular ejection fraction and nonischemic cardiomyopathy. Mortality in women was one-half that of men, although events were scarce and without significant differences (2.9% vs. 5.6%; p = 0.25).
Conclusions:
Women with left bundle branch block and implanted CRT have a lower rate of ventricular tachyarrhythmias than men. All-cause mortality in patients is, at least, similar between female and male subjects.
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