title: A Comparison of Women and Men Undergoing Catheter Ablation for Sustained Monomorphic Ventricular Tachycardia.
abstract: Women are underrepresented in clinical studies on catheter ablation (CA) for ventricular tachycardia (VT). The role of gender as a predictor for VT recurrence after CA is unclear and complication rates have not been compared in a large cohort.
  
  
  
  We analyzed data of consecutive patients undergoing CA for sustained monomorphic VT at our center between 2005 and 2015. A total of 948 patients underwent 1314 ablation procedures: 114 patients without structural heart disease (SHD) (48% female), 486 with coronary artery disease (CAD) (9% female), 301 with nonischemic cardiomyopathy (NICM) (22% female), and 46 with arrhythmogenic right ventricular cardiomyopathy (ARVC) (17% female). Women with CAD and NICM were younger than men at first ablation (63 years vs. 68 years, P = 0.05; resp. 53 years vs. 59 years, P = 0.026) with no other significant differences in baseline characteristics. Age, LVEF, NYHA-class, and VT-recurrence but not gender were independently associated with increased mortality in CAD and NICM. Mortality rates in patients with no SHD and ARVC are low in men (0%, 2.6%) and women (1.8%, 0%).
  
  
  
  Although heart disease tends to present later in women, our data do not suggest that women are referred later than men. Women with CAD or NICM and VT present for ablation at younger age with disease severity comparable to men. VT ablation in women can be accomplished with success- and complication rates comparable to male patients in both those with and without SHD.
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.|The Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Baldinger
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Romero
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujii
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Epstein
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Michaud
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Roy
authors.initials: R
authors.lastname: John
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: catheter ablation; complications; gender differences; structural heart disease; ventricular tachycardia