title: Sex differences in cardiac electrophysiology and clinical arrhythmias: epidemiology, therapeutics, and mechanisms.
abstract: Sex differences in cardiac electrophysiological properties and arrhythmias are evident in epidemiologic and investigative studies as well as in daily patient care. At the supraventricular level, women are at increased risk of sick sinus syndrome and atrioventricular (AV) node re-entrant tachycardia, whereas men manifest more AV block and accessory pathway-mediated arrhythmias. At the ventricular level, women are generally at higher risk of long QT-associated arrhythmias, whereas men are more likely to present with early repolarization, idiopathic ventricular fibrillation, and Brugada syndromes. Great advances have been made in unraveling the fundamental mechanisms underlying sex differences in ventricular arrhythmias, particularly those associated with abnormal repolarization. Conversely, the basis for male-predominant arrhythmia risk in structural heart disease and differences in supraventricular arrhythmia susceptibility are poorly understood. Beyond biological differences, arrhythmia occurrence and patient care decisions are also influenced by gender-related factors. This article reviews the current knowledge regarding the nature and underlying mechanisms of sex differences in basic cardiac electrophysiology and clinical arrhythmias.
authors: Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada; Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada.
authors: Rafik
authors: R
authors: Tadros
authors: Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Québec, Canada.
authors: Anh-Tuan
authors: AT
authors: Ton
authors: Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Québec, Canada.
authors: Céline
authors: C
authors: Fiset
authors: Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada; Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada. Electronic address: stanley.nattel@icm-mhi.org.
authors: Stanley
authors: S
authors: Nattel
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D002036:Bundle of His / Q000503:physiopathology*; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D014943:Global Health; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000889:Anti-Arrhythmia Agents