title: Sex and Catheter Ablation for Ventricular Tachycardia: An International Ventricular Tachycardia Ablation Center Collaborative Group Study.
abstract: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison.
  
  
  
  To compare outcomes between women and men with structural heart disease undergoing VT ablation.
  
  
  
  Investigator-initiated, multicenter, observational study performed between 2002 and 2013, conducted by the International VT Ablation Center Collaborative Group, consisting of 12 high-volume ablation centers. Consecutive patients with structural heart disease undergoing VT ablation were studied. Structural heart disease was defined as left ventricular ejection fraction less than 55%, hypertrophic cardiomyopathy, or right ventricular cardiomyopathy, with scar confirmed during electroanatomic mapping.
  
  
  
  Catheter ablation.
  
  
  
  Ventricular tachycardia-free survival and transplant-free survival were compared between women and men. Cox proportional hazard modeling was performed.
  
  
  
  Of 2062 patients undergoing ablation, 266 (12.9%) were women. Mean (SD) age was 62.4 (13.3) years and 1095 (53.1%) had ischemic cardiomyopathy. Compared with men, women were younger, with higher left ventricular ejection fraction and less VT storm. Despite this, women had higher rates of 1-year VT recurrence following ablation (30.5% vs 25.3%; P = .03). This difference was only partially explained by higher prevalence of nonischemic cardiomyopathy among women and was actually most pronounced among those with ischemic cardiomyopathy.
  
  
  
  In 12 high-volume ablation centers, women with structural heart disease have worse VT-free survival following ablation than men. Whether this is owing to differences in referral pattern, arrhythmia substrate, or undertreatment requires further study.
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: David S
authors.initials: DS
authors.lastname: Frankel
authors.affiliation: University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Roderick
authors.initials: R
authors.lastname: Tung
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santangeli
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Tzou
authors.affiliation: University of California Los Angeles Cardiac Arrhythmia Center, University of California Los Angeles Health System.
authors.forename: Marmar
authors.initials: M
authors.lastname: Vaseghi
authors.affiliation: Albert Einstein College of Medicine/Montefiore Medical Center, New York, New York.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagashima
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Usha
authors.initials: U
authors.lastname: Tedrow
authors.affiliation: Intermountain Medical Center Heart Institute, Murray, Utah.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.affiliation: Veteran's Affairs Medical Center, University of Minnesota, Minneapolis.
authors.forename: Venkatakrishna N
authors.initials: VN
authors.lastname: Tholakanahalli
authors.affiliation: University of Kansas Medical Center, Kansas City.
authors.forename: Raghuveer
authors.initials: R
authors.lastname: Dendi
authors.affiliation: University of Kansas Medical Center, Kansas City.
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy
authors.affiliation: University of Kansas Medical Center, Kansas City.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
authors.affiliation: University of Maryland Medical Center, Baltimore.
authors.forename: Timm
authors.initials: T
authors.lastname: Dickfeld
authors.affiliation: Intermountain Medical Center Heart Institute, Murray, Utah.
authors.forename: J Peter
authors.initials: JP
authors.lastname: Weiss
authors.affiliation: Baylor St Luke's Medical Center/Texas Heart Institute, Houston.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Mathuria
authors.affiliation: Hospital San Raffaele, Milan, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vergara
authors.affiliation: Baylor St Luke's Medical Center/Texas Heart Institute, Houston.
authors.forename: Mehul
authors.initials: M
authors.lastname: Patel
authors.affiliation: Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakahara
authors.affiliation: Veteran's Affairs Medical Center, University of Minnesota, Minneapolis.
authors.forename: Kairav
authors.initials: K
authors.lastname: Vakil
authors.affiliation: Section of Cardiac Electrophysiology, Division of Cardiology, University of Colorado, Aurora.
authors.forename: William H
authors.initials: WH
authors.lastname: Sauer
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Callans
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
authors.affiliation: Hospital San Raffaele, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Bella
authors.affiliation: University of California Los Angeles Cardiac Arrhythmia Center, University of California Los Angeles Health System.
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
authors.affiliation: Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Francis E
authors.initials: FE
authors.lastname: Marchlinski
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors; D017180:Tachycardia, Ventricular / Q000628:therapy*; D016896:Treatment Outcome