TY - JOUR
T1 - Sex differences in Cardiac electronic device implantation
T2 - Outcomes from an Australian multi-centre clinical quality registry
AU - Eccleston, David
AU - Cehic, Daniel
AU - Young, Glenn
AU - Lin, Tina
AU - Pavia, Steven
AU - Chowdhury, Enayet K.
AU - Reid, Christopher
AU - Liew, Danny
AU - King, Ben
AU - Tan, Isabel
AU - Phillips, Karen
AU - O'Donnell, David
AU - for the GenesisCare Outcomes Registry Investigators
N1 - Funding Information:
The authors would like to acknowledge the dedication and hard work of the GenesisCare research coordinators and investigators in developing this data registry, and in collecting, auditing and assisting with data analysis for this report.
Publisher Copyright:
© 2021
PY - 2021/8
Y1 - 2021/8
N2 - Background: There is uncertainty regarding whether outcomes after Cardiac Implantable Electronic Devices (CIED) differ between women and men. There are no prospectively collected data regarding Australian CIED outcomes. This study aimed to determine whether the characteristics and outcomes of Australian patients undergoing CIED implantation differ by sex. Methods: We prospectively followed 5,360 patients undergoing CIED implantation between 2015 and 2019 in a large multi-centre Australian registry. Patient characteristics, procedural data, medications and clinical outcomes to 1 year were analysed. Results: The mean age was 76.2 + 11.2 years, and 2022 (37.7%) were female. Women were older than men at device implantation (77.0 ± 11.6 years vs. 75.5 ± 10.9 years, p < 0.001). Most implants were de novo (79.7%). Pacing was more commonly for sick sinus syndrome in women than men (54.4% vs. 47.2%, p < 0.001) and less often for A-V block (28.3% vs. 35.1%, p < 0.001). Adverse events at 30 days were low compared to international cohorts, for mortality (0.06%) and major complications (0.6%). There were no significant sex differences (women vs. men) for death (HR 1.33, 95% CI 0.58–3.13, p = 0.49) or major complications (HR 1.41, 95% 95% CI 0.65–3.03, p = 0.39). At 1-year, there was no difference in major complications or risk-adjusted all-cause mortality (HR 1.05, 95% CI 0.70–1.29, p = 0.77) between women and men. Conclusions: Clinical practice and 30-day outcomes after CIED implantation in Australia are consistent with international reports. There were no differences in procedural complication rates or clinical outcomes at 1-year between women and men, regardless of age or CIED system implanted.
AB - Background: There is uncertainty regarding whether outcomes after Cardiac Implantable Electronic Devices (CIED) differ between women and men. There are no prospectively collected data regarding Australian CIED outcomes. This study aimed to determine whether the characteristics and outcomes of Australian patients undergoing CIED implantation differ by sex. Methods: We prospectively followed 5,360 patients undergoing CIED implantation between 2015 and 2019 in a large multi-centre Australian registry. Patient characteristics, procedural data, medications and clinical outcomes to 1 year were analysed. Results: The mean age was 76.2 + 11.2 years, and 2022 (37.7%) were female. Women were older than men at device implantation (77.0 ± 11.6 years vs. 75.5 ± 10.9 years, p < 0.001). Most implants were de novo (79.7%). Pacing was more commonly for sick sinus syndrome in women than men (54.4% vs. 47.2%, p < 0.001) and less often for A-V block (28.3% vs. 35.1%, p < 0.001). Adverse events at 30 days were low compared to international cohorts, for mortality (0.06%) and major complications (0.6%). There were no significant sex differences (women vs. men) for death (HR 1.33, 95% CI 0.58–3.13, p = 0.49) or major complications (HR 1.41, 95% 95% CI 0.65–3.03, p = 0.39). At 1-year, there was no difference in major complications or risk-adjusted all-cause mortality (HR 1.05, 95% CI 0.70–1.29, p = 0.77) between women and men. Conclusions: Clinical practice and 30-day outcomes after CIED implantation in Australia are consistent with international reports. There were no differences in procedural complication rates or clinical outcomes at 1-year between women and men, regardless of age or CIED system implanted.
KW - Cardiac Implantable Electronic Device
KW - Outcomes
KW - Quality
KW - Registry
KW - Sex
UR - http://www.scopus.com/inward/record.url?scp=85108451925&partnerID=8YFLogxK
U2 - 10.1016/j.ijcha.2021.100828
DO - 10.1016/j.ijcha.2021.100828
M3 - Article
C2 - 34235244
AN - SCOPUS:85108451925
SN - 2352-9067
VL - 35
JO - IJC Heart & Vasculature
JF - IJC Heart & Vasculature
M1 - 100828
ER -