Influence of Gender on Arrhythmia Characteristics and Outcome in the Multicenter UnSustained Tachycardia Trial
Why the study?
Does gender influence the characteristics and outcomes of EP-guided therapy in patients with coronary disease, ejection fraction <=40%, and spontaneous nonsustained ventricular tachycardia?
Population
Patients with coronary disease, ejection fraction <=40%, and spontaneous nonsustained ventricular…
Comparison
Female gender (observational analysis of gender… vs Male gender
Design
Cohort
Follow-up
2 years
Authors
Discussion
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Member takes
Implication
Supports gender-equitable EP-guided therapy use in ischemic NSVT; hypothesis-generating pending randomized confirmation.
Key Points
- To assess whether gender influences the inducibility of ventricular arrhythmias and survival outcomes in patients with coronary disease receiving electrophysiologically guided therapy.
- Analyzed baseline characteristics and outcomes by gender in patients with coronary disease, ejection fraction ≤40%, and spontaneous nonsustained ventricular tachycardia enrolled in the Multicenter UnSustained Tachycardia Trial (MUSTT).
- Evaluated gender-specific rates of inducible sustained ventricular arrhythmias via electrophysiologic testing and survival outcomes under electrophysiologically guided management.
- Women represented 14% of the overall population and were significantly less likely than men to exhibit inducible sustained ventricular arrhythmias (24% vs 36%, P < 0.001).
- ICD implantation rates in the electrophysiologically guided therapy group did not differ significantly between women and men (53% vs 45%, P = 0.38).
- Gender had no statistically significant impact on arrhythmic death or cardiac arrest (2-year event rate: 9% in women vs 12% in men; adjusted HR 0.88) or overall mortality (2-year event rate: 32% in women vs 21% in men; adjusted HR 1.51).
Structured PICO
Does gender influence the characteristics and outcomes of EP-guided therapy in patients with coronary disease, ejection fraction <=40%, and spontaneous nonsustained ventricular tachycardia?
P
Population
Patients with coronary disease, ejection fraction <=40%, and spontaneous nonsustained ventricular tachycardia enrolled in the Multicenter UnSustained Tachycardia Trial (MUSTT). Women comprised 14% of the overall population.
I
Intervention
Female gender (observational analysis of gender differences in patients receiving electrophysiologic (EP)-guided therapy)
C
Comparator
Male gender
O
Outcome
Arrhythmic death or cardiac arrest, and overall mortalityhard clinical
Gender does not appear to significantly influence the outcome and benefit of EP-guided therapy in patients with ischemic heart disease and nonsustained ventricular tachycardia, although women have lower rates of inducible arrhythmias.
Limitations
- small numbers of women in the trial, small differences in outcome may not be apparent
Cite This Study
Russo et al. (2004) studied this question.