ORLANDO, FLA. — Men with heart failure and/or bundle branch block are preferentially treated more aggressively with implantable devices than are women with similar health status, a review of nearly 11,000 cases suggests.
The 10,931 patients, of whom 4,138 (38%) were women, were listed in an administrative database and represented consecutive admissions to any of numerous hospitals owned by Hospital Corporation of America. All had a diagnosis of heart failure, bundle branch block, or both, and underwent a primary procedure of pacemaker, cardiac resynchronization therapy pacemaker (CRT-P), implantable cardioverter defibrillator (ICD), or cardiac resynchronization therapy defibrillator (CRT-D) implantation, Robert Fishel, M.D., said at an international conference on women, heart disease, and stroke.
Women received 52% of the pacemakers, 33% of the CRT-Ps, 22% of the ICDs, and 21% of the CRT-Ds implanted, said Dr. Fishel of the J.F.K. Medical Center, Atlantis, Fla. Logistic regression analysis showed that men were significantly less likely than women to receive a pacemaker (odds ratio 0.35) and more likely to receive an ICD (OR 1.34) or CRT-D (OR 1.48). There was no significant difference in device utilization of CRP-Ps between sexes.
After controlling for device, diagnoses, age, and comorbidities, there were no significant differences between men and women in measured clinical outcomes, including mortality, postoperative stroke, postoperative infection, or ICD or pacemaker mechanical malfunction. However, further research is needed to determine if these differences in device use have any long-term effects on outcomes in women, he said.