TY - JOUR
T1 - Sex and Catheter Ablation for Ventricular Tachycardia
T2 - An International Ventricular Tachycardia Ablation Center Collaborative Group Study
AU - Frankel, David S.
AU - Tung, Roderick
AU - Santangeli, Pasquale
AU - Tzou, Wendy S.
AU - Vaseghi, Marmar
AU - Di Biase, Luigi
AU - Nagashima, Koichi
AU - Tedrow, Usha
AU - Bunch, T. Jared
AU - Tholakanahalli, Venkatakrishna N.
AU - Dendi, Raghuveer
AU - Reddy, Madhu
AU - Lakkireddy, Dhanunjaya
AU - Dickfeld, Timm
AU - Weiss, J. Peter
AU - Mathuria, Nilesh
AU - Vergara, Pasquale
AU - Patel, Mehul
AU - Nakahara, Shiro
AU - Vakil, Kairav
AU - Sauer, William H.
AU - Callans, David J.
AU - Natale, Andrea
AU - Stevenson, William G.
AU - Della Bella, Paolo
AU - Shivkumar, Kalyanam
AU - Marchlinski, Francis E.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Importance: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison.Objective: To compare outcomes between women and men with structural heart disease undergoing VT ablation.Design, Setting, and Participants: Investigator-initiated, multicenter, observational study performed between 2002 and 2013, conducted by the International VT Ablation Center Collaborative Group, consisting of 12 high-volume ablation centers. Consecutive patients with structural heart disease undergoing VT ablation were studied. Structural heart disease was defined as left ventricular ejection fraction less than 55%, hypertrophic cardiomyopathy, or right ventricular cardiomyopathy, with scar confirmed during electroanatomic mapping.Exposures: Catheter ablation.Main Outcomes and Measures: Ventricular tachycardia-free survival and transplant-free survival were compared between women and men. Cox proportional hazard modeling was performed.Results: Of 2062 patients undergoing ablation, 266 (12.9%) were women. Mean (SD) age was 62.4 (13.3) years and 1095 (53.1%) had ischemic cardiomyopathy. Compared with men, women were younger, with higher left ventricular ejection fraction and less VT storm. Despite this, women had higher rates of 1-year VT recurrence following ablation (30.5% vs 25.3%; P = .03). This difference was only partially explained by higher prevalence of nonischemic cardiomyopathy among women and was actually most pronounced among those with ischemic cardiomyopathy.Conclusions and Relevance: In 12 high-volume ablation centers, women with structural heart disease have worse VT-free survival following ablation than men. Whether this is owing to differences in referral pattern, arrhythmia substrate, or undertreatment requires further study.
AB - Importance: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison.Objective: To compare outcomes between women and men with structural heart disease undergoing VT ablation.Design, Setting, and Participants: Investigator-initiated, multicenter, observational study performed between 2002 and 2013, conducted by the International VT Ablation Center Collaborative Group, consisting of 12 high-volume ablation centers. Consecutive patients with structural heart disease undergoing VT ablation were studied. Structural heart disease was defined as left ventricular ejection fraction less than 55%, hypertrophic cardiomyopathy, or right ventricular cardiomyopathy, with scar confirmed during electroanatomic mapping.Exposures: Catheter ablation.Main Outcomes and Measures: Ventricular tachycardia-free survival and transplant-free survival were compared between women and men. Cox proportional hazard modeling was performed.Results: Of 2062 patients undergoing ablation, 266 (12.9%) were women. Mean (SD) age was 62.4 (13.3) years and 1095 (53.1%) had ischemic cardiomyopathy. Compared with men, women were younger, with higher left ventricular ejection fraction and less VT storm. Despite this, women had higher rates of 1-year VT recurrence following ablation (30.5% vs 25.3%; P = .03). This difference was only partially explained by higher prevalence of nonischemic cardiomyopathy among women and was actually most pronounced among those with ischemic cardiomyopathy.Conclusions and Relevance: In 12 high-volume ablation centers, women with structural heart disease have worse VT-free survival following ablation than men. Whether this is owing to differences in referral pattern, arrhythmia substrate, or undertreatment requires further study.
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U2 - 10.1001/jamacardio.2016.2361
DO - 10.1001/jamacardio.2016.2361
M3 - Article
C2 - 27556589
AN - SCOPUS:85011909534
SN - 2380-6583
VL - 1
SP - 938
EP - 944
JO - JAMA cardiology
JF - JAMA cardiology
IS - 8
ER -
