Sex differences in Cardiac electronic device implantation: Outcomes from an Australian multi-centre clinical quality registry

• Published in: International journal of cardiology. Heart & vasculature Vol. 35; p. 100828
• Main Authors: Eccleston, David, Cehic, Daniel, Young, Glenn, Lin, Tina, Pavia, Steven, Chowdhury, Enayet K., Reid, Christopher, Liew, Danny, King, Ben, Tan, Isabel, Phillips, Karen, O'Donnell, David
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-08-2021; Elsevier
• Subjects: Cardiac Implantable Electronic Device; Original Paper; Outcomes; Quality; Registry; Sex; VT/VF; DDD; Sex; NOAC; VVI; EPS; A-V; Cardiac Implantable Electronic Device; Outcomes; ILR; Quality; VDD; CIED; MI; CRT-P; GCOR; OR; AF; NCDR; Registry; ICD; PCI; CABG; PM; HF; CRT-P, Cardiac Resynchronisation therapy pacemaker; PM, Pacemaker; A-V, Atrio-ventricular; VT/VF, Ventricular tachycardia/fibrillation; VDD, Ventricular sensing dual chamber pacing; AF, Atrial fibrillation; MI, Myocardial infarction; CIED, Cardiac implantable electronic device; HF, Heart failure; DDD, Dual chamber sensing and pacing; OR, Odds ratio; NCDR, National Cardiovascular data registry; EPS, Electrophysiological study; ILR, Implantable loop recorder; NOAC, Non-Vitamin K-dependent Oral Anticoagulant; VVI, Ventricular sensing and pacing; CABG, Coronary artery bypass graft; GCOR, GenesisCare Cardiovascular Outcomes Registry; PCI, Percutaneous coronary intervention; ICD, Implantable cardioverter-defibrillator
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2021.100828

There is uncertainty regarding whether outcomesafter Cardiac Implantable Electronic Devices (CIED) differ between women and men. There are no prospectively collected data regarding Australian CIED outcomes. Thisstudy aimedto determine whether the characteristics and outcomes of Australian patients undergoing CIED implantation differ by sex.
We prospectively followed 5,360patients undergoing CIED implantation between 2015 and 2019 in a large multi-centre Australian registry. Patient characteristics, procedural data, medications and clinical outcomes to 1 year were analysed.
The mean age was 76.2 + 11.2 years, and 2022 (37.7%) were female. Women were older than men at device implantation (77.0 ± 11.6 years vs. 75.5 ± 10.9 years, p < 0.001). Most implants were de novo (79.7%). Pacing was more commonly for sick sinus syndrome in women than men (54.4% vs. 47.2%, p < 0.001) and less often for A-V block (28.3% vs. 35.1%, p < 0.001). Adverse events at 30 days were low comparedto international cohorts, for mortality (0.06%) and major complications (0.6%). There were no significant sex differences(women vs. men) for death (HR 1.33, 95% CI 0.58–3.13, p = 0.49) or major complications (HR 1.41, 95% 95% CI 0.65–3.03, p = 0.39). At 1-year, there was no difference inmajor complications or risk-adjusted all-cause mortality (HR 1.05, 95% CI 0.70–1.29, p = 0.77) between women and men.
Clinical practice and 30-day outcomes after CIED implantation in Australia are consistent with international reports. There were no differences in procedural complication rates or clinical outcomes at 1-year between women and men, regardless of age or CIED system implanted.