ArticleJournal of the American Heart Association2022
Sex-Based Differences in Selected Cardiac Implantable Electronic Device Use: A 10-Year Statewide Patient Cohort.
Article in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- Diversity, equity, and inclusion in arrhythmia care: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Inequities in access to life-saving cardiac devices for heart failure: a comparative analysis of Chile and Mexico.BMC cardiovascular disorders · 2026Article
- Article
- Sex-specific short- and long-term outcomes in patients with leadless cardiac pacemakers.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- Pacemaker therapy through a sex-specific lens: a narrative review of clinical and procedural disparities.Frontiers in cardiovascular medicine · 2026Review
- Disparities in the Clinical Provision of Deep Brain Stimulation: A Systematic Scoping Review and Grounded-Theory Qualitative Analysis.Movement disorders clinical practice · 2025Article
- Sex Differences and Long-Term Outcomes in Patients with Left Bundle Branch Area Pacing Compared with Right Ventricular Pacing.Journal of clinical medicine · 2025Article
- Cardiac rhythm devices in heart failure with reduced ejection fraction - role, timing, and optimal use in contemporary practice. European Journal of Heart Failure expert consensus document.European journal of heart failure · 2025Review
- Gender and Age Differences in the Evaluation and Clinical Outcomes of Patients with Palpitations.Journal of general internal medicine · 2024Observational
- Implantable Cardioverter-Defibrillators Among Older Survivors of Out-of-Hospital Cardiac Arrest.Journal of the American Heart Association · 2024Article
- The Appropriateness of Medical Devices Is Strongly Influenced by Sex and Gender.Life (Basel, Switzerland) · 2024Review
- Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Cardiac implantable electronic devices (CIEDs) include pacemakers, cardioverter defibrillators, and resynchronization therapy. This study aimed to assess CIED implantation and outcomes by sex and indication. Methods and Results This was a retrospective cohort study of adults with cardiovascular hospitalizations in New South Wales, Australia (2008 to 2018). CIED implantation in patients with arrhythmia, cardiomyopathy, and syncope were examined. Subcategories (complete heart block, atrial fibrillation/atrial flutter, ventricular tachycardia/ventricular fibrillation/cardiac arrest, sick sinus syndrome, and ischemic and nonischemic cardiomyopathy) were investigated. Primary outcome was implantation of CIEDs in men versus women adjusted for age and comorbidities. Secondary outcomes were trends over time, time to implant, length of stay, emergency status, and 30-day survival. Of 1 291 258 patients with cardiovascular admissions, 287 563 had arrhythmia, cardiomyopathy, or syncope and 29 080 (2.3%) received a CIED (22 472 pacemakers, 6808 defibrillators, 3207 resynchronization therapy). Women with arrhythmia, cardiomyopathy, or syncope were less likely to have pacemakers (adjusted odds ratio [aOR], 0.78 [95% CI, 0.76-0.80]), defibrillators (aOR, 0.4, [95% CI, 0.40-0.45]) and resynchronization therapy (aOR, 0.66 [95% CI, 0.61-0.71]). Differences persisted across subcategories, including fewer pacemakers in complete heart block (aOR, 0.89 [95% CI, 0.80-0.98]) and syncope (aOR, 0.70 [95% CI, 0.63-0.79]); fewer defibrillators in ventricular tachycardia/ventricular fibrillation/cardiac arrest (aOR, 0.69 [95% CI, 0.61-0.77]); and less resynchronization therapy in cardiomyopathy (aOR, 0.62 [95% CI, 0.51-0.75]). Men and women receiving devices had higher 30-day survival compared with those who did not receive a device, and 30-day survival was similar between men and women receiving devices. Conclusions Lower CIED implantation was seen in women versus men, across nearly all indications, including complete heart block and ventricular tachycardia/ventricular fibrillation/cardiac arrest. The underuse of cardiac devices among women may arguably reflect a sex bias and requires further research.
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