Study examines gender differences in ICD placement

A study published in the Feb. 7 issue of Annals of Internal Medicine examined differences between males and females among patients who received implantable cardioverter-defibrillators (ICDs). Researchers studied health records for 6,021 men and women in Ontario, Canada, who were referred to cardiologists specializing in ICD placement.

ICDs have been shown to reduce mortality as primary prevention among persons with myocardial infarction or heart failure and as secondary prevention after cardiac arrest. Current clinical guidelines for ICD use apply to both males and females, yet it is not clear if there are sex differences in patient outcomes.

The study revealed that while both sexes were equally likely to receive an ICD if referred to a cardiology specialist, women were 1.6 times more likely to experience complications after implantation at both early and later follow-up points.

One of the most common issues was movement of the electrical leads of the ICD, which sometimes required the cardiologists to reposition them, the study reported. Women also were 31 percent less likely than men to receive appropriate shock and 27 percent less likely to receive appropriate antitachycardia therapy from the device.

According to the author of an accompanying editorial in the same journal, the value of ICDs in women has not been thoroughly studied, as women are underrepresented in research. Gender differences need to be considered for patients referred to ICD therapy.

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