Gender Differences in Selection of Permanent Pacemaker Implantation at Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal

Abstract

Background: Permanent pacemaker implantation is a minimally invasive surgical procedure in the management of patients with cardiac rhythm disturbances. Previous studies have reported gender differences in pacemaker selection. There is lack of evidences in selection of pacemaker mode with respect to gender in Nepal. Therefore, this study was performed to compare the frequency of implantation between men and women.Objectives: This study was performed to compare the frequency of implantation rate between men and women. Methods:The present study is based on all consecutive pacemaker implantations in a single centre between April 2014 and May 2015. A total of 116 patients were categorized into two cohorts according to the type of pacemaker implanted-single chamber or dual chamber. Data were presented as means ± standard deviation (SD) for continuous variables and as proportions for categorical variables. Comparison of continuous variables between the groups was made with independent Student's t-test. For discrete variables distribution between groups were compared with Chi-square test. Results:The mean age (±SD) of total population at implant was 64.08 (± 15.09) years. Dual chamber units were implanted in 44 (37.93%) of patients, single chamber in 72 (62.06%). Only 14 women (31.81%) received dual chamber compared with 42 women (58.33%) who received single chamber (Chi-square=18, DF=1, P = 0.0084). Complete atrioventricular block was the commonest (56.03%) indication for permanent pacemaker insertion followed by sick sinus syndrome (33.62%), symptomatic high-grade AV block (11.20%). Hypertension (dual chamber 21.55%, single chamber 40.51%) was the most common comorbidity in both cohorts. Conclusions:Women were more likely to receive single chamber systems and less likely to receive dual chamber systems than men.

Study of clinical profile and indications of Permanent Pacemaker Insertion in Nepali population presenting to tertiary care centre in Nepal

“…Main reason for it was financial constraint and even more so in female probably due to gender bias. Similar results regarding gender related difference was found in study done by Khanal J et al 12 . Study done by Nowak B et al 16 in Germany also showed similar sex differences in dual chamber pacemaker implantation, even more so in old age individuals and in study done by Lamas GA et al in USA 17 , whereas study done by Veerareddy et al 18 in USA showed no sex differences in the selection of pacemaker.…”

“…Nepal for the last 20 years, there is no large scale published data of pacemaker implantations. Few studies and reports have been published regarding clinical profile, short term outcome, experiences and gender differences in pacemaker implantation in different centre including MCVTC[9][10][11][12][13] .The objective of this study is to analyze the clinical profile and indications of permanent pacing in Nepali population presenting to Age Distribution of Patients with PPI…”

Trends and Profile of Permanent Pacemaker Implantation in Nepal. Experience From Tertiary Cardiac Center (SGNHC) From 2001 to 2020.

“…The trends in the use of more number of single chamber pacemakers as in our study is similar to the other study done at various cardiac centers of our country [3][4][5][6][7] and India. 8 However the trend of implantation of pacemaker in other developed countries at USA 9 and Australia 10 have showed majority of their patients received dual chamber pacemaker.…”

“…2 The similar findings has been shown in various study done in our part of the country. [3][4][5][6][7] The mean age of the study population was 65 years which were similar to the other study done at India with mean age of 60.5, 8 In Poland mean age of 63.5 years 12 and similar to the other study done in our country. [3][4][5][6][7] However in other registries and the 11 th world survey mean age ranged from 65 to 80 years in patients who underwent PPM implantation.…”

“…2 There are few studies and reports have been published regarding clinical profile, short term outcome, experiences in pacemaker implantation in different center in our part of the world. [3][4][5][6][7] This study intended focusing on permanent pacemaker implantation (PPI) of 19 years data at the referral tertiary cardiac center which will highlight and reflect a clear picture of the trends and profile of PPI implantation in Nepal.…”