A Comparison of Women and Men Undergoing Catheter Ablation for Sustained Monomorphic Ventricular Tachycardia.

Baldinger, Samuel Hannes; Kumar, Saurabh; Romero, Jorge; Fujii, Akira; Epstein, Laurence M; Michaud, Gregory F; John, Roy; Tedrow, Usha B; Stevenson, William G (2017). A Comparison of Women and Men Undergoing Catheter Ablation for Sustained Monomorphic Ventricular Tachycardia. Journal of cardiovascular electrophysiology, 28(2), pp. 201-207. Wiley-Blackwell 10.1111/jce.13127

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INTRODUCTION

Women are underrepresented in clinical studies on catheter ablation (CA) for ventricular tachycardia (VT). The role of gender as a predictor for VT recurrence after CA is unclear and complication rates have not been compared in a large cohort.

METHODS AND RESULTS

We analyzed data of consecutive patients undergoing CA for sustained monomorphic VT at our center between 2005 and 2015. A total of 948 patients underwent 1314 ablation procedures: 114 patients without structural heart disease (SHD) (48% female), 486 with coronary artery disease (CAD) (9% female), 301 with nonischemic cardiomyopathy (NICM) (22% female), and 46 with arrhythmogenic right ventricular cardiomyopathy (ARVC) (17% female). Women with CAD and NICM were younger than men at first ablation (63 years vs. 68 years, P = 0.05; resp. 53 years vs. 59 years, P = 0.026) with no other significant differences in baseline characteristics. Age, LVEF, NYHA-class, and VT-recurrence but not gender were independently associated with increased mortality in CAD and NICM. Mortality rates in patients with no SHD and ARVC are low in men (0%, 2.6%) and women (1.8%, 0%).

CONCLUSIONS

Although heart disease tends to present later in women, our data do not suggest that women are referred later than men. Women with CAD or NICM and VT present for ablation at younger age with disease severity comparable to men. VT ablation in women can be accomplished with success- and complication rates comparable to male patients in both those with and without SHD.

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