Mohamed, MO, contractor, T, zachariah, D, van spall, H, parwani, P, minissian, M, Rashid, M, martin, G, barker, D, Patwala, A and Mamas, M (2021) Sex disparities in the choice of cardiac resynchronization therapy device utilized: an analysis of trends, predictors and outcomes. Canadian Journal of Cardiology, 37 (1). pp. 86-93. ISSN 0828-282X

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There is limited evidence on the influence of sex on the decision to implant a cardiac resynchronization therapy device with pacemaker (CRT-P) or defibrillator (CRT-D) and the existence of sex-dependent differences in complications that may affect this decision.
All patients undergoing de novo CRT implantation (2004-2014) in the United States National Inpatient Sample were included and stratified by device type (CRT-P and CRT-D). Multivariable logistic regression models were conducted to assess the association of female sex with receipt of CRT-D and periprocedural complications.
Out of 400,823 weighted CRT procedural records, the overall percentages of women undergoing CRT-P and CRT-D implantations were 41.5% and 27.8%, respectively, and these percentages increased compared with men over the study period. Women were less likely to receive CRT-D (odds ratio 0.66, 95% confidence interval 0.64-0.67), and this trend remained stable throughout the study period ( P = 0.06). Furthermore, compared with men, women were associated with increased odds of procedure-related complications (bleeding, thoracic, and cardiac) in the CRT-D group but not in the CRT-P group. Factors such as atrial fibrillation, malignancies, renal failure, advanced age (> 60 years), and admission to nonurban/small hospitals favoured the receipt of CRT-P over CRT-D, whereas history of ischemic heart disease, cardiac arrest ,or ventricular arrhythmias favoured the receipt of CRT-D over CRT-P.
Women were associated with persistently reduced odds of receipt of CRT-D compared with men over an 11-year period. This study identifies important factors that predict the choice of CRT device offered to patients in the United States.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at and Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: cardiac resynchronization, pacemaker, defibrillator, sex trends, outcomes
Subjects: H Social Sciences > H Social Sciences (General)
Q Science > Q Science (General)
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Depositing User: Symplectic
Date Deposited: 13 Feb 2020 09:24
Last Modified: 21 Jun 2021 10:08

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