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, de la Concha, JF, Martinez, JG, Vinolas, X, Porres, JM, Anguera, I, Porro-Fernandez, R, Quesada-Ocete, B, de la Guia-Galipienso, F, Palanca, V, Jimenez, J, Quesada-Ocete, J, Sanchis-Gomar, F, UMBRELLA Res Grp
Publicada:
1 jun 2021
Ahead of Print:
1 jun 2021
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. (C) 2021 by the American College of Cardiology Foundation.
Filiaciones:
Quesada, A:
Gen Univ Hosp Consortium Valencia, Cardiol Serv, Arrhythmia Unit, Av Tres Creus 2, Valencia 46014, Spain
Catholic Univ Valencia San Vicente Martir, Sch Med, Valencia, Spain
Arteaga, F:
Catholic Univ Valencia San Vicente Martir, Sch Med, Valencia, Spain
Romero-Villafranca, R:
Royal Acad Valencian Culture, Valencia, Spain
Perez-Alvarez, L:
Univ Hosp Complex A Coruna, Arrhythmia Unit, Cardiol Serv, La Coruna, Spain
Martinez-Ferrer, J:
Univ Hosp Araba, Cardiol Serv, Arrhythmia Unit, Vitoria, Alava, Spain
Alzueta-Rodriguez, J:
Virgen de la Victoria Hosp, Cardiol Serv, Arrhythmia Unit, Malaga, Spain
de la Concha, JF:
Infanta Cristina Hosp, Cardiol Serv, Arrhythmia Unit, Badajoz, Spain
Martinez, JG:
Gen Univ Hosp Alicante, Cardiol Serv, Arrhythmia Unit, Alicante, Spain
Vinolas, X:
Santa Creu & St Pau Hosp, Arrhythmia Unit, Cardiol Serv, Barcelona, Spain
Porres, JM:
Univ Hosp Donostia, Intens Care Serv, Arrhythmia Unit, San Sebastian, Spain
Anguera, I:
Bellvitge Hosp, Cardiol Serv, Arrhythmia Unit, Barcelona, Spain
Porro-Fernandez, R:
San Pedro Alcantara Hosp, Cardiol Serv, Arrhythmia Unit, Caceres, Spain
Quesada-Ocete, B:
Johannes Gutenberg Univ Mainz, Univ Med Ctr, Ctr Cardiol, Dept Cardiol Electrophysiol 2, Mainz, Germany
de la Guia-Galipienso, F:
Marina Baixa Hosp, Cardiol Serv, Alicante, Spain
REMA Sports Cardiol Clin, Alicante, Spain
Palanca, V:
Gen Univ Hosp Consortium Valencia, Cardiol Serv, Arrhythmia Unit, Av Tres Creus 2, Valencia 46014, Spain
Jimenez, J:
Gen Univ Hosp Consortium Valencia, Cardiol Serv, Arrhythmia Unit, Av Tres Creus 2, Valencia 46014, Spain
Quesada-Ocete, J:
Gen Univ Hosp Consortium Valencia, Cardiol Serv, Arrhythmia Unit, Av Tres Creus 2, Valencia 46014, Spain
Catholic Univ Valencia San Vicente Martir, Sch Med, Valencia, Spain
Sanchis-Gomar, F:
Univ Valencia, Dept Physiol, Fac Med, Ave Blasco Ibanez 15, Valencia 46010, Spain
INCLIVA Biomed Res Inst, Valencia, Spain
Stanford Univ, Div Cardiovasc Med, Sch Med, Stanford, CA USA
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