Influence of gender on ICD implantation for primary and secondary prevention of sudden cardiac death.
OBJECTIVE
This study sought to investigate the influence of gender on access to ICD therapy and examine the influence of gender on subsequent ICD shock experience.


RESULTS
The records of 353 consecutive patients (140 and 213 secondary prevention, respectively) who received their first ICD between January 2000 and March 2004 were reviewed. All patients fulfilled criteria for primary or secondary prevention ICD implantation. Baseline characteristics and ICD shock experiences were compared. Female patients were younger and less likely to have a history of ischaemic heart disease or atrial arrhythmias (P<0.01). In contrast, female patients were more likely to have heart failure and diabetes (P<0.01). Markedly fewer females received an ICD for either primary (M:F ratio 8.5:1, P<0.01) or secondary (M:F ratio 4.5:1, P<0.01) prevention. Further, significantly fewer female patients received an ICD for MADIT II indications (M:F 11.2:1, P<0.01). Over the mean follow-up of 1.8+/-1.1 years, gender had no influence upon the likelihood of receiving either an appropriate or an inappropriate shock (P=ns).


CONCLUSIONS
Although male patients accounted for the great majority (85%) of all ICD recipients, there was no evidence of influence of gender on the likelihood of receiving an appropriate or inappropriate shock.
Davis
Darryl R
DR
Division of Cardiology, University of Ottawa Heart Institute, H145-1053 Carling Avenue, Ottawa, Ontario, Canada K1Y 4E9.
Tang
Anthony S L
AS
Lemery
Robert
R
Green
Martin S
MS
Gollob
Michael H
MH
Birnie
David H
DH
D000328:Adult; D000367:Age Factors; D000368:Aged; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000628:therapy; D012189:Retrospective Studies; D012737:Sex Factors