ORLANDO, FLA. — Men with heart failure and/or bundle branch block appear to be 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 and/or bundle branch block 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., reported 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 (odds ratio 1.34) or CRT-D (odds ratio 1.48). There was no significant difference in device utilization of CRP-Ps between sexes.
Further research is needed to determine if the differences in device use among men and women have any long-term effects on outcomes in women, he said.