my personal edition > interventional cardiology > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Women More Likely Than Men to Have Complications Related to ICD Implantation: Presented at AHA

By Emma Hitt, PhD

ORLANDO, FL -- November 7, 2007 -- Women are more likely than men to experience complications while in the hospital after receiving an implantable cardioverter defibrillator (ICD), new research suggests.

Pam N. Peterson, MD, Cardiologist, Assistant Professor of Medicine, Denver Health Medical Center, Denver, Colorado, presented the findings here at the American Heart Association (AHA) 2007 Scientific Sessions.

From a registry of ICD patients, a multivariate analysis assessed all in-hospital complications following ICD and biventricular ICD implantation between January 2005 and April 2007 in a population of 59,833 patients (73% male and 27% female).

In comparison with the men, women had significantly more heart failure (88% vs 83%), severe New York Heart Association (NYHA) functional status (57% vs 50%), and nonischemic cardiomyopathy (47% vs 28%). Women were also significantly more likely than men to receive biventricular ICDs (46% vs 39%).

"Women had a significantly higher risk of any complications and major complications," the authors note. Major complications included cardiac arrest, perforation, valve injury, coronary venous dissection, hemothorax, pneumothorax, deep phlebitis, transient ischemic attack/stroke, tamponade, myocardial infarction, and atrioventricular fistula.

"We were unable to determine why adverse event rates were higher in this study," said Dr. Peterson. "One hypothesis is that women generally have a smaller body size, but we did not have a measure of body size and were unable to adjust for this variable." She added that currently, defibrillators are "one size fits all," with no differences in how defibrillators are made for men and women.

"This study is really the first of three steps," Dr. Peterson pointed out. "First, we have to establish that women are at higher risk. Next, we need to determine the reasons for the higher adverse event rate observed in women. And third, we need to evaluate potential measures to reduce risk."

However, she added that the results of this study should not be interpreted to mean that women should not receive ICDs. "Women may still derive benefit from device implantation, and clinical trial criteria should still be applied equally to women and men," she said. "But the study represents an important opportunity to improve outcomes for women receiving ICDs for primary prevention."


[Presentation title: Differences in Implantation-Related Complications Between Men and Women Receiving ICD Therapy for Primary Prevention. Abstract 3628]

E-Mail this DGDispatch to a colleague

To print, use this version