Female clinicians were more likely than male clinicians to report delayed referral (41.8% vs 19.8%) and late or incorrect diagnosis (49.4% vs 15.8%) for female arrhythmia patients.
Cross-Sectional (n=212)
Yes
Clinicians perceive significant disparities in arrhythmia care driven by age, cognitive impairment, and mental health, with female clinicians more likely to recognize sex-based disparities.
Absolute Event Rate: 41.8% vs 19.8%
Abstract Background Disparities in arrhythmia care are increasingly recognised, yet remain incompletely characterised across the patient pathway. This European Heart Rhythm Association (EHRA) survey explored clinician-reported perceptions of inequity across diagnosis, pharmacological management, procedural referral and follow-up. Methods A 30-question survey was disseminated via the EHRA between November 2025 and January 2026, with 212 responses from professionals across 35 countries. Results Respondents were predominantly consultant electrophysiologists (67.5%), with 39.6% identifying as female. Most (68.4%) reported no prior training in equity or inclusive care. Across the arrhythmia care pathway, disparities were most frequently attributed to patient vulnerability, particularly cognitive impairment (72.5%), age 80 years (63.8%) and mental health disease (61.3%). Differences related to socioeconomic status, language and other social factors were also commonly reported. Female sex and minority ethnic background were each reported to influence care in 24.1% of responses. Age 80 years was consistently identified as the strongest determinant of disparities in referral, diagnosis and outcomes, influencing referral for arrhythmia evaluation (65.8%), catheter ablation (77.9%) and outcomes following ablation (68.1%). Socioeconomic and ethnic factors showed more modest but consistent effects, while sex-based differences were less frequently reported. However, female respondents were more likely than male respondents to report delayed referral (female respondents: 41.8%; male respondents: 19.8%) and late or incorrect diagnosis (49.4% vs 15.8%) in female patients, as well as delayed referral for catheter ablation (36.5% vs 10.3%) and device implantation (23.0% vs 7.0%). Only one-third of respondents (33.3%) felt that current international guidelines adequately address diversity, equity and inclusion in arrhythmia care. Conclusions Clinicians perceive disparities in arrhythmia care across multiple patient and social factors. Whilst age and vulnerability were most frequently perceived to influence care, sex and ethnicity were also recognised by a substantial proportion of respondents. Perceptions varied according to respondent characteristics, with female clinicians more likely to report disparities amongst female patients. Limited training and institutional frameworks highlight opportunities for targeted interventions.
Mills et al. (Wed,) conducted a cross-sectional in Arrhythmia care disparities (n=212). Female clinician respondent vs. Male clinician respondent was evaluated on Perception of delayed referral in female patients. Female clinicians were more likely than male clinicians to report delayed referral (41.8% vs 19.8%) and late or incorrect diagnosis (49.4% vs 15.8%) for female arrhythmia patients.