What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Structural heart disease with ventricular tachycardia (n=10206). Intervention: Female sex vs. Male sex. Primary outcome: Ventricular tachycardia recurrence (HR 1.04, 95% CI 0.9-1.22, p=0.57).

December 1, 2022Open Access

Sex differences on outcomes of catheter ablation of ventricular tachycardia in patients with structural heart disease: A real-world systematic review and meta-analysis

Q: What does this research mean for the field?

Female sex is not associated with a statistically significant difference in ventricular tachycardia recurrence or all-cause mortality compared to male sex following catheter ablation in patients with structural heart disease. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

NPNarut PrasitlumkumHawaii Pacific University LNLeenhapong NavaravongUniversity of California, Riverside ADAditya DesaiUniversity of California, Riverside

Key Result

Female sex was not associated with a statistically significant difference in ventricular tachycardia recurrence (HR 1.04) or all-cause mortality compared to male sex following catheter ablation.

Study Design

Type

Meta-Analysis (n=10,206)

Structured PICO

Does female sex impact VT recurrence and mortality in patients with structural heart disease undergoing catheter ablation of VT?

Population

10,206 adults with structural heart disease undergoing catheter ablation of ventricular tachycardia (VT) across 22 retrospective studies, mean age 62.5, 12.8% women.

Intervention

Female sex (assessing sex differences in outcomes of catheter ablation of VT)

Comparator

Male sex

Outcome

VT recurrence rates and all-cause mortalityhard clinical

This meta-analysis suggests that clinical outcomes of VT catheter ablation, including recurrence and mortality, are similar between men and women with structural heart disease, despite women being significantly underrepresented in studies.

Main Result

Effect estimate: HR 1.04 (95% CI 0.9-1.22)

p-value: p=0.57

Limitations

Only retrospective studies were included, introducing potential selection bias.
Substantial heterogeneity was found in the analysis due to diversities in demographic data, methodologies, and procedural aspects.
Unable to appraise whether sex had any impact on noncardiac mortality given unavailable data.
Liable to referral bias for VT ablation in women because of the small proportion in included studies.

Abstract

Background: Sex differences have diversely affected cardiac diseases. Little is known whether these differences impact outcomes of catheter ablation of ventricular tachycardia (VT). Objectives: To assess the impact of sex differences on outcomes of catheter ablation of VT. Methods: Databases were searched from inception through December 2021. Effect estimates from individual studies were extracted and combined using the random-effects, generic inverse variance method of DerSimonian and Laird. The outcomes of interest included VT recurrence rates, all-cause mortality, and composite outcomes of mortality, left ventricular assistant device use, and heart transplantation following VT ablation. Results: .071). Conclusion: Our contemporary analysis suggests that sex may have no impact on clinical outcomes of catheter ablation of VT in patients with structural heart disease, though women are the underrepresented. However, recent VT ablation registries have involved more women in their studies. Future studies with a higher proportion of women are encouraged to verify the current perception.

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