English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

The Issue Implantable cardioverter defibrillators (ICDs) are used for primary prevention in those who are at risk of sudden cardiac death (SCD) and for secondary prevention in those who have been resuscitated from a cardiac arrest. Several randomized controlled trials have found that treatment with an ICD reduced mortality, and the device has been assumed to be equally effective in women and men (Antiarrhythmics versus Implantable Defibrillators Investigators 1997; Bardy et al. 2005; Moss et al. 2002). Indeed, clinical guidelines do not consider the sex of the patient in their recommendations for ICD implantation. Although ICDs are now routinely implanted in patients regardless of their sex, recent studies have questioned whether there are differences in ICD use and outcomes between women and men. The weight of evidence suggests that women are less likely than men to undergo ICD implantation. Indeed, landmark randomized controlled trials of ICDs enrolled approximately 75% men (Bardy et al. 2005; Moss et al. 2002). Data from Ontario indicate that compared with men, far fewer women with myocardial infarction or heart failure have had the device implanted for primary prevention, and this difference has persisted over time (MacFadden et al. 2009). Women are also far less likely to undergo ICD implantation for secondary prevention after cardiac arrest, although the differences in device utilization for post-cardiac arrest indications have been attenuated over time (MacFadden et al. 2009). Although few studies have examined the reasons for differences in ICD use between the sexes, there are several potential explanations, including lower rates of referral of women, reduced likelihood of accepting women for the procedure and women’s refusal to undergo defibrillator implantation. Outcomes for women who undergo ICD implantation have not been fully evaluated. Data from the US National Cardiovascular Disease Registry (NCDR) ICD Registry suggest that women have a higher risk of in-hospital complications than men (Peterson et al. 2009). However, ICD complications are more likely to occur after discharge from hospital, and these events were not explored. In a study of defibrillator-related early complications from the Ontario ICD Database, complication rates were found to be higher than previously anticipated (Lee et al. 2010). Rates of major, minor and any complications at 45 days were 4.1%, 5.1% and 7.4%, respectively. The majority of these events occurred after discharge from the index ICD-implantation admission, as evidenced by the 0.8% in-hospital complication rate. Importantly, early implant-related

Do Women Experience the Same Benefits as Men from Implantable Cardioverter Defibrillators?