Sex-related differences in the presentation and outcome of out-of-hospital cardiopulmonary arrest: A multiyear, prospective, population-based study

Wigginton, Jane G.; Pepe, Paul E.; Bedolla, John; DeTamble, Lucy A.; Atkins, James M.

doi:10.1097/00003246-200204001-00002

Cited by 96 publications

(86 citation statements)

References 34 publications

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“…Women are less likely to have witnessed arrests, bystander CPR, EMS CPR, and intravenous (IV) medications. 11,27 There is also controversy with respect to survival advantage for women for shockable or other rhythms. 28,29 Six studies to date have evaluated the age-sex interaction.…”

Section: Academic Emergency Medicinementioning

confidence: 99%

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

et al. 2014

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Section: Academic Emergency Medicinementioning

confidence: 99%

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

et al. 2014

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“…Women are less prone to ventricular arrhythmias except long QT-induced torsade de pointes and drug-induced ventricular arrhythmia, and the incidence of sudden cardiac death is generally lower in women than in men. 46,47 An analysis of the Framingham population revealed that women had a significantly lower incidence of sudden cardiac death in all age groups, with almost two-thirds occurring in subjects without previous diagnoses of coronary artery disease. 47 The lower rate of coronary artery disease in women may contribute to the lower incidence of sudden cardiac death; 48,49 however, differences in susceptibility to ventricular arrhythmia may also play a role.…”

Section: Implantable Cardioverter Defibrillatormentioning

confidence: 99%

Outcomes in Women Undergoing Electrophysiological Procedures

Biase

Basile

Al‐Ahmad

2013

Arrhythmia &Amp; Electrophysiology Review

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The number of invasive electrophysiological procedures is steadily increasing in Western countries, as the age of the population increases and technologies advance. In recent years, gender-related differences in cardiac rhythm disorders have been increasingly appreciated, which can potentially have a great impact on the outcomes of invasive electrophysiological procedures. Among supraventricular arrhythmias, women have a higher incidence of atrioventricular nodal re-entrant tachycardia and a significantly lower incidence of atrioventricular re-entrant tachycardia compared with males, and present to ablation procedures later and after having failed more antiarrhythmic drugs. The results of catheter ablation of atrial fibrillation in women have been reported worse than in men. This finding is possibly due to a later referral of females to ablation procedures, who present older and with a higher incidence of long-standing persistent atrial fibrillation. With regard to cardiac device implantation procedures, a smaller survival benefit from prophylactic implantable cardioverter defibrillator (ICD) implantation has been shown in women, essentially due to gender-specific differences in the clinical course of patients with severe left ventricular dysfunction, with women dying predominantly from non-arrhythmic causes. On the other side, the clinical outcome of cardiac resynchronisation therapy seems to be more favourable in women, who experience a greater degree of reverse left ventricular remodelling and a striking decrease of heart failure events or mortality after biventricular pacing. This review will summarise the available evidence on gender-related differences in outcomes of invasive electrophysiological procedures.

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“…Reproduced with permission from Albert et al 21 A prospective population-based study in Dallas of outof-hospital cardiac arrest found that women more often presented with asystole and pulseless electrical activity, and men usually had ventricular tachycardia and ventricular fibrillation. 20 In a retrospective analysis of 355 survivors (271 men, 84 women) of out-of-hospital cardiac arrest survivors in Boston, the only independent predictor of cardiac mortality and total mortality in women was the presence of coronary artery disease. A left ventricular ejection fraction (LVEF) <40%, which was the strongest independent predictor of total and cardiac mortality in men, did not have the same prognostic significance in women.…”

Section: Ventricular Arrhythmias and Sudden Cardiac Deathmentioning

confidence: 99%

Arrhythmias in Women

Curtis

Narasimha

2012

Clinical Cardiology

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There are important gender differences in cardiac electrophysiology that affect the epidemiology, presentation, and prognosis of various arrhythmias. Women have been noted to have higher resting heart rates compared to men. They also have a longer QT interval, which puts them at an increased risk for drug-induced torsades de pointes. Women with atrial fibrillation are at a higher risk of stroke, and they are less likely to receive anticoagulation and ablation procedures compared to men. Women have a lower risk of sudden cardiac death and are less likely to have known coronary artery disease at the time of an event compared to men. Both men and women have been shown to derive an equal survival benefit from implantable cardioverter defibrillators and cardiac resynchronization therapy, although these devices are significantly underutilized in women. Women also appear to have a better response to cardiac resynchronization therapy in terms of reduced numbers of hospitalizations and more robust reverse ventricular remodeling. Further studies are required to elucidate the underlying pathophysiology of these sex differences in cardiac arrhythmias. IntroductionSex differences in cardiac electrophysiology affect the epidemiology, presentation, and prognosis of various arrhythmias. These sex differences can have important clinical and therapeutic implications. Although the exact reason for these differences is not known, the potential mechanisms include differences in cardiac size, structure, and the different ways in which hormones, drugs, and electrolytes affect cardiac ion channels in men and women. The purpose of this review is to provide a synopsis of the important gender differences with respect to arrhythmias and to summarize updates from recent studies.

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Sex-related differences in the presentation and outcome of out-of-hospital cardiopulmonary arrest: A multiyear, prospective, population-based study

Cited by 96 publications

References 34 publications

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

Outcomes in Women Undergoing Electrophysiological Procedures

Arrhythmias in Women

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