Key result
Women with unexplained syncope and bundle branch block had a lower mortality rate than men (4.5 vs. 7.3 per 100 person-years) and a lower risk of AV block and cardiac pacing.
Why the study?
Despite awareness that sex influences arrhythmia incidence, etiology, and outcomes, differences in presentation and outcomes between men and women with syncope and bundle branch block have not been examined.
Are there sex-related differences in the risk of AV block, need for cardiac pacing, and mortality in patients with unexplained syncope and bundle branch block?
Cohort
Are there sex-related differences in the risk of AV block, need for cardiac pacing, and mortality in patients with unexplained syncope and bundle branch block?
Absolute Event Rate: 4.5% vs 7.3%
Women with unexplained syncope and bundle branch block have a lower risk of AV block, lesser need for cardiac pacing, and lower mortality compared to men.
Women with unexplained syncope and BBB had lower AVB and pacing risk than men; supports sex-stratified risk assessment but leaves open prospective validation.
Objective: To analyze if there are sex-related differences in patients with unexplained syncope and bundle branch block (BBB). Background: Despite increasing awareness that sex is a major determinant of the incidence, etiology, and the outcomes of different arrhythmias, no studies have examined differences in presentation and outcomes between men and women with syncope and BBB. Methods: Cohort study of consecutive patients with unexplained syncope and BBB was included from January 2010 to January 2021 with a median follow-up time of 3.4 years [interquartile range (IQR) 1.7-6.0 years]. They were evaluated by a stepwise workup protocol based on electrophysiological study (EPS) and long-term follow-up with an implantable cardiac monitor (ICM). Results: = 0.046). The mortality rate was lower in women (4.5 per 100 person-years [95% CI 3.1-6.4 per 100 person-years] vs. 7.3 per 100 person-years [95% CI 5.9-9.1 per 100 person-years]). Conclusions: Compared to men, women with unexplained syncope and BBB have a lower risk of AVB and of requiring cardiac pacing. A stepwise diagnostic approach has a similar diagnostic yield in both sexes, and it seems appropriate to guide the treatment and avoid unnecessary pacemaker implantation, especially in women.
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Francisco‐Pascual et al. (2022) conducted a cohort in Unexplained syncope and bundle branch block. Female sex vs. Male sex was evaluated on Mortality rate. Women with unexplained syncope and bundle branch block had a lower mortality rate than men (4.5 vs. 7.3 per 100 person-years) and a lower risk of AV block and cardiac pacing.
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