Sex-Specific Ventricular Arrhythmias and Mortality in Cardiac Resynchronization Therapy Recipients.
Por:
Quesada A, Arteaga F, Romero-Villafranca R, Perez-Alvarez L, Martinez-Ferrer J, Alzueta-Rodriguez J, Fernández de la Concha J, Martinez JG, Viñolas X, Porres JM, Anguera I, Porro-Fernández R, Quesada-Ocete B, de la Guía-Galipienso F, Palanca V, Jimenez J, Quesada-Ocete J, Sanchis-Gomar F and UMBRELLA Research Group
Publicada:
1 jun 2021
Ahead of Print:
24 dic 2020
Resumen:
OBJECTIVES: The study goal was to examine whether there are sex-related differences in the incidence of ventricular arrhythmias and mortality in CRT-defibrillator (CRT-D) recipients. BACKGROUND: Few studies have evaluated sex-related benefits of cardiac resynchronization therapy (CRT). Moreover, data on sex-related differences in the occurrence of ventricular tachyarrhythmias in this population are limited. METHODS: A multicenter retrospective study was conducted in 460 patients (355 male subjects and 105 female subjects) from the UMBRELLA (Incidence of Arrhythmia in Spanish Population With a Medtronic Implantable Cardiac Defibrillator Implant) national registry. Patients were followed up through remote monitoring after the first implantation of a CRT-D during a median follow-up of 2.2 ± 1.0 years. Sex differences were analyzed in terms of ventricular arrhythmia-treated incidence and death during the follow-up period, with a particular focus on primary prevention patients. RESULTS: Baseline New York Heart Association functional class was worse in women compared with that in men (67.0% of women in New York Heart Association functional class III vs. 49.7% of men; p = 0.003), whereas women had less ischemic cardiac disease (20.8% vs. 41.7%; p < 0.001). Female sex was an independent predictor of ventricular arrhythmias (hazard ratio: 0.40; 95% confidence interval: 0.19 to 0.86; p = 0.020), as well as left ventricular ejection fraction and nonischemic cardiomyopathy. Mortality in women was one-half that of men, although events were scarce and without significant differences (2.9% vs. 5.6%; p = 0.25). CONCLUSIONS: Women with left bundle branch block and implanted CRT have a lower rate of ventricular tachyarrhythmias than men. All-cause mortality in patients is, at least, similar between female and male subjects.
Filiaciones:
Quesada A:
Arrhythmia Unit, Cardiology Service, General University Hospital Consortium of Valencia, Valencia, Spain
School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
Arteaga F:
School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
Romero-Villafranca R:
Royal Academy of Valencian Culture, Valencia, Spain
Perez-Alvarez L:
Arrhythmia Unit, Cardiology Service, University Hospital Complex A Coruña, A Coruña, Spain
Martinez-Ferrer J:
Arrhythmia Unit, Cardiology Service, University Hospital of Araba, Vitoria, Álava, Spain
Alzueta-Rodriguez J:
Arrhythmia Unit, Cardiology Service, Virgen de la Victoria Hospital, Málaga, Spain
Fernández de la Concha J:
Arrhythmia Unit, Cardiology Service, Infanta Cristina Hospital, Badajoz, Spain
Martinez JG:
Arrhythmia Unit, Cardiology Service, General University Hospital of Alicante, Alicante, Spain
Viñolas X:
Arrhythmia Unit, Cardiology Service, Santa Creu and Sant Pau Hospital, Barcelona, Spain
Porres JM:
Arrhythmia Unit, Intensive Care Service, University Hospital of Donostia, San Sebastian, Spain
Anguera I:
Arrhythmia Unit, Cardiology Service, Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
Porro-Fernández R:
Arrhythmia Unit, Cardiology Service, San Pedro de Alcántara Hospital, Cáceres, Spain
Quesada-Ocete B:
Department of Cardiology II/Electrophysiology, Center of Cardiology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
:
Cardiology Service of Marina Baixa Hospital, Alicante, Spain
REMA Sports Cardiology Clinic, Denia, Alicante, Spain
Palanca V:
Arrhythmia Unit, Cardiology Service, General University Hospital Consortium of Valencia, Valencia, Spain
Jimenez J:
Arrhythmia Unit, Cardiology Service, General University Hospital Consortium of Valencia, Valencia, Spain
Quesada-Ocete J:
Arrhythmia Unit, Cardiology Service, General University Hospital Consortium of Valencia, Valencia, Spain
School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
Sanchis-Gomar F:
Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain
Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA. Electronic address:
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