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Female Aspects of Electrocardiography and Cardiac Arrhythmias

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Manual of Gynecardiology

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Abstract

Normograms of the ECG are derived from the standard male patient. Women have a longer duration of the P-wave and PR-interval, while the QRS complex is smaller with a lower voltage. Non-specific ST-T changes are more often present in women than in men and vary by age. Paroxysmal supraventricular tachycardia’s (PSVT) are later diagnosed in women than in men. Women with atrial fibrillation (AF) have more symptoms, undergo fewer cardioversions and have a worse quality of life than men. Women more often develop Torsades de pointes (TdP) with some antiarrhythmic drugs. Although implantable defibrillator devices (ICD) therapy in secondary prevention are equally beneficial in both genders, they are less often applied in women. The quality of mammograms may be reduced by the presence of an implanted medical device.

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References

  1. Ghani A, Maas AH, Delnoy PP, Ramdat Misier AR, Ottervanger JP, Elvan A. Sex-based differences in cardiac arrhythmias, ICD utilisation and cardiac resynchronisation therapy. Neth Heart J. 2011;19(1):35–40.

    Article  CAS  PubMed  Google Scholar 

  2. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33(21):2719–47.

    Article  PubMed  Google Scholar 

  3. Priori SG, Blomstrom-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36(41):2793–867.

    Article  PubMed  Google Scholar 

  4. Smetana P, Malik M. Sex differences in cardiac autonomic regulation and in repolarisation electrocardiography. Pflugers Arch. 2013;465(5):699–717.

    Article  CAS  PubMed  Google Scholar 

  5. Alpert MA, Terry BE, Hamm CR, Fan TM, Cohen MV, Massey CV, et al. Effect of weight loss on the ECG of normotensive morbidly obese patients. Chest. 2001;119(2):507–10.

    Article  CAS  PubMed  Google Scholar 

  6. LaMonte CS, Freiman AH. The electrocardiogram after mastectomy. Circulation. 1965;32(5):746–54.

    Article  CAS  PubMed  Google Scholar 

  7. Macfarlane PW, Colaco R, Stevens K, Reay P, Beckett C, Aitchison T. Precordial electrode placement in women. Neth Heart J. 2003;11(3):118–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Rautaharju PM, Park L, Rautaharju FS, Crow R. A standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol. 1998;31(1):17–29.

    Article  CAS  PubMed  Google Scholar 

  9. Surawicz B. How to increase the accuracy of electrocardiogram’s interpretation and stimulate the interest of the interpreters? J Electrocardiol. 2010;43(3):191–3.

    Article  PubMed  Google Scholar 

  10. Yong CM, Froelicher V, Wagner G. The electrocardiogram at a crossroads. Circulation. 2013;128(1):79–82.

    Article  PubMed  Google Scholar 

  11. Liu K, Ballew C, Jacobs Jr DR, Sidney S, Savage PJ, Dyer A, et al. Ethnic differences in blood pressure, pulse rate, and related characteristics in young adults. The CARDIA study. Hypertension. 1989;14(2):218–26.

    Article  CAS  PubMed  Google Scholar 

  12. Larsen JA, Kadish AH. Effects of gender on cardiac arrhythmias. J Cardiovasc Electrophysiol. 1998;9(6):655–64.

    Article  CAS  PubMed  Google Scholar 

  13. Burke JH, Ehlert FA, Kruse JT, Parker MA, Goldberger JJ, Kadish AH. Gender-specific differences in the QT interval and the effect of autonomic tone and menstrual cycle in healthy adults. Am J Cardiol. 1997;79(2):178–81.

    Article  CAS  PubMed  Google Scholar 

  14. Rautaharju PM, Zhang ZM, Gregg RE, Haisty Jr WK, Vitolins MZ, Curtis AB, et al. Normal standards for computer-ECG programs for prognostically and diagnostically important ECG variables derived from a large ethnically diverse female cohort: the Women’s Health Initiative (WHI). J Electrocardiol. 2013;46(6):707–16.

    Article  PubMed  Google Scholar 

  15. Pham TV, Rosen MR. Sex, hormones, and repolarization. Cardiovasc Res. 2002;53(3):740–51.

    Article  CAS  PubMed  Google Scholar 

  16. Lehmann MH, Hardy S, Archibald D, Quart B, DJ MN. Sex difference in risk of torsade de pointes with d,l-sotalol. Circulation. 1996;94(10):2535–41.

    Article  CAS  PubMed  Google Scholar 

  17. Verkerk AO, Wilders R, Tan HL. Gender disparities in torsade de pointes ventricular tachycardia. Neth Hear J. 2007;15(12):405–11.

    Article  CAS  Google Scholar 

  18. Anneken L, Baumann S, Vigneault P, Biliczki P, Friedrich C, Xiao L, et al. Estradiol regulates human QT-interval: acceleration of cardiac repolarization by enhanced KCNH2 membrane trafficking. Eur Heart J. 2016;37(7):640–50.

    Article  PubMed  Google Scholar 

  19. Rautaharju PM, Zhou SH, Wong S, Calhoun HP, Berenson GS, Prineas R, et al. Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol. 1992;8(7):690–5.

    CAS  PubMed  Google Scholar 

  20. Bernal O, Moro C. Cardiac arrhythmias in women. Rev Esp Cardiol. 2006;59(6):609–18.

    Article  PubMed  Google Scholar 

  21. Rautaharju PM, Surawicz B, Gettes LS, Bailey JJ, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009;53(11):982–91.

    Article  PubMed  Google Scholar 

  22. Nielsen JB, Graff C, Rasmussen PV, Pietersen A, Lind B, Olesen MS, et al. Risk prediction of cardiovascular death based on the QTc interval: evaluating age and gender differences in a large primary care population. Eur Heart J. 2014;35(20):1335–44.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rijnbeek PR, van Herpen G, Bots ML, Man S, Verweij N, Hofman A, et al. Normal values of the electrocardiogram for ages 16–90 years. J Electrocardiol. 2014;47(6):914–21.

    Article  PubMed  Google Scholar 

  24. Rasmussen PV, Nielsen JB, Pietersen A, Graff C, Lind B, Struijk JJ, et al. Electrocardiographic precordial ST-segment deviations and the risk of cardiovascular death: results from the Copenhagen ECG Study. J Am Heart Assoc. 2014;3(3):e000549.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Rautaharju PM, Kooperberg C, Larson JC, LaCroix A. Electrocardiographic predictors of incident congestive heart failure and all-cause mortality in postmenopausal women: the Women’s Health Initiative. Circulation. 2006;113(4):481–9.

    Article  PubMed  Google Scholar 

  26. Kadish AH, Greenland P, Limacher MC, Frishman WH, Daugherty SA, Schwartz JB. Estrogen and progestin use and the QT interval in postmenopausal women. Ann Noninvasive Electrocardiol. 2004;9(4):366–74.

    Article  PubMed  Google Scholar 

  27. Rivero A, Curtis AB. Sex differences in arrhythmias. Curr Opin Cardiol. 2010;25(1):8–15.

    Article  PubMed  Google Scholar 

  28. Liuba I, Jonsson A, Safstrom K, Walfridsson H. Gender-related differences in patients with atrioventricular nodal reentry tachycardia. Am J Cardiol. 2006;97(3):384–8.

    Article  PubMed  Google Scholar 

  29. Yarnoz MJ, Curtis AB. More reasons why men and women are not the same (gender differences in electrophysiology and arrhythmias). Am J Cardiol. 2008;101(9):1291–6.

    Article  PubMed  Google Scholar 

  30. Tawam M, Levine J, Mendelson M, Goldberger J, Dyer A, Kadish A. Effect of pregnancy on paroxysmal supraventricular tachycardia. Am J Cardiol. 1993;72(11):838–40.

    Article  CAS  PubMed  Google Scholar 

  31. Lessmeier TJ, Gamperling D, Johnson-Liddon V, Fromm BS, Steinman RT, Meissner MD, et al. Unrecognized paroxysmal supraventricular tachycardia. Potential for misdiagnosis as panic disorder. Arch Intern Med. 1997;157(5):537–43.

    Article  CAS  PubMed  Google Scholar 

  32. Deneke T, Mugge A, Muller P, de Groot JR. Therapeutic implications of gender differences in supraventricular cardiac arrhythmias: lessons of life cannot be learned in a day. Expert Rev Cardiovasc Ther. 2009;7(8):879–82.

    Article  PubMed  Google Scholar 

  33. Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946–52.

    Article  CAS  PubMed  Google Scholar 

  34. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Arch Intern Med. 1995;155(5):469–73.

    Article  CAS  PubMed  Google Scholar 

  35. Friberg L, Bergfeldt L. Atrial fibrillation prevalence revisited. J Intern Med. 2013;274(5):461–8.

    Article  CAS  PubMed  Google Scholar 

  36. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC endorsed by the European Stroke Organisation (ESO). Eur Heart J. 2016;37(38):2893–962.

    Google Scholar 

  37. Marijon E, Le Heuzey JY, Connolly S, Yang S, Pogue J, Brueckmann M, et al. Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study. Circulation. 2013;128(20):2192–201.

    Article  CAS  PubMed  Google Scholar 

  38. Andersson T, Magnuson A, Bryngelsson IL, Frobert O, Henriksson KM, Edvardsson N, et al. Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: a nationwide cohort study of 9519 patients. Int J Cardiol. 2014;177(1):91–9.

    Article  PubMed  Google Scholar 

  39. Dagres N, Nieuwlaat R, Vardas PE, Andresen D, Levy S, Cobbe S, et al. Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Heart Survey on atrial fibrillation. J Am Coll Cardiol. 2007;49(5):572–7.

    Article  PubMed  Google Scholar 

  40. Ko D, Rahman F, Schnabel RB, Yin X, Benjamin EJ, Christophersen IE. Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis. Nat Rev Cardiol. 2016;13(6):321–32.

    Article  PubMed  Google Scholar 

  41. Piccini JP, Simon DN, Steinberg BA, Thomas L, Allen LA, Fonarow GC, et al. Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF registry. JAMA Cardiol. 2016;1(3):282–91.

    Article  PubMed  Google Scholar 

  42. Chao TF, Liu CJ, Chen SJ, Wang KL, Lin YJ, Chang SL, et al. Atrial fibrillation and the risk of ischemic stroke: does it still matter in patients with a CHA2DS2-VASc score of 0 or 1? Stroke. 2012;43(10):2551–5.

    Article  CAS  PubMed  Google Scholar 

  43. Hamaguchi S, Yokoshiki H, Kinugawa S, Tsuchihashi-Makaya M, Yokota T, Takeshita A, et al. Effects of atrial fibrillation on long-term outcomes in patients hospitalized for heart failure in Japan: a report from the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). Circ J. 2009;73(11):2084–90.

    Article  CAS  PubMed  Google Scholar 

  44. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J. 2012;33(12):1500–10.

    Article  PubMed  Google Scholar 

  45. Friberg L, Benson L, Rosenqvist M, Lip GY. Assessment of female sex as a risk factor in atrial fibrillation in Sweden: nationwide retrospective cohort study. BMJ. 2012;344:e3522.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Emdin CA, Wong CX, Hsiao AJ, Altman DG, Peters SA, Woodward M, et al. Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies. BMJ. 2016;532:h7013.

    Article  PubMed  Google Scholar 

  47. Nezu T, Hosomi N, Kondo K, Aoki S, Matsumoto M, Kobayashi S, et al. Greater severity of neurological defects in women admitted with atrial fibrillation-related stroke. Circ J. 2016;80(1):250–5.

    Article  PubMed  Google Scholar 

  48. Yoshida K, Obokata M, Kurosawa K, Sorimachi H, Kurabayashi M, Negishi K. Effect of sex differences on the association between stroke risk and left atrial anatomy or mechanics in patients with atrial fibrillation. Circ Cardiovasc Imaging. 2016. PMID: 27729360.

    Google Scholar 

  49. Goncalves A, Hung CL, Claggett B, Nochioka K, Cheng S, Kitzman DW, et al. Left atrial structure and function across the spectrum of cardiovascular risk in the elderly: the atherosclerosis risk in communities study. Circ Cardiovasc Imaging. 2016;9(2):e004010.

    PubMed  PubMed Central  Google Scholar 

  50. Coutinho T, Borlaug BA, Pellikka PA, Turner ST, Kullo IJ. Sex differences in arterial stiffness and ventricular-arterial interactions. J Am Coll Cardiol. 2013;61(1):96–103.

    Article  PubMed  Google Scholar 

  51. Hsu JC, Maddox TM, Kennedy KF, Katz DF, Marzec LN, Lubitz SA, et al. Oral anticoagulant therapy prescription in patients with atrial fibrillation across the spectrum of stroke risk: insights from the NCDR PINNACLE registry. JAMA Cardiol. 2016;1(1):55–62.

    Article  PubMed  Google Scholar 

  52. Avgil Tsadok M, Gagnon J, Joza J, Behlouli H, Verma A, Essebag V, et al. Temporal trends and sex differences in pulmonary vein isolation for patients with atrial fibrillation. Heart Rhythm. 2015;12(9):1979–86.

    Article  PubMed  Google Scholar 

  53. Shantsila E, Wolff A, Lip GY, Lane DA. Gender differences in stroke prevention in atrial fibrillation in general practice: using the GRASP-AF audit tool. Int J Clin Pract. 2015;69(8):840–5.

    Article  CAS  PubMed  Google Scholar 

  54. Roten L, Rimoldi SF, Schwick N, Sakata T, Heimgartner C, Fuhrer J, et al. Gender differences in patients referred for atrial fibrillation management to a tertiary center. Pacing Clin Electrophysiol. 2009;32(5):622–6.

    Article  PubMed  Google Scholar 

  55. Patel D, Mohanty P, Di Biase L, Sanchez JE, Shaheen MH, Burkhardt JD, et al. Outcomes and complications of catheter ablation for atrial fibrillation in females. Heart Rhythm. 2010;7(2):167–72.

    Article  PubMed  Google Scholar 

  56. Rienstra M, Van Veldhuisen DJ, Hagens VE, Ranchor AV, Veeger NJ, Crijns HJ, et al. Gender-related differences in rhythm control treatment in persistent atrial fibrillation: data of the Rate Control Versus Electrical Cardioversion (RACE) study. J Am Coll Cardiol. 2005;46(7):1298–306.

    Article  PubMed  Google Scholar 

  57. Rolden HJ, Grutters JP, van der Wilt GJ, Maas AH. Closing the information gap between clinical and postmarketing trials: the case of dabigatran. Eur Heart J Cardiovasc Pharmacother. 2015;1(3):153–6.

    Article  PubMed  Google Scholar 

  58. Maas AH, Euler M, Bongers MY, Rolden HJ, Grutters JP, Ulrich L, et al. Practice points in gynecardiology: abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy. Maturitas. 2015;82(4):355–9.

    Article  PubMed  Google Scholar 

  59. Kannel WB, Wilson PW, D’Agostino RB, Cobb J. Sudden coronary death in women. Am Heart J. 1998;136(2):205–12.

    Article  CAS  PubMed  Google Scholar 

  60. Shaw LJ, Bugiardini R, Merz CN. Women and ischemic heart disease: evolving knowledge. J Am Coll Cardiol. 2009;54(17):1561–75.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Ripplinger CM, Noujaim SF, Linz D. The nervous heart. Prog Biophys Mol Biol. 2016;120(1–3):199–209.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Hart EC, Charkoudian N. Sympathetic neural regulation of blood pressure: influences of sex and aging. Physiology. 2014;29(1):8–15.

    Article  CAS  PubMed  Google Scholar 

  63. Whang W, Kubzansky LD, Kawachi I, Rexrode KM, Kroenke CH, Glynn RJ, et al. Depression and risk of sudden cardiac death and coronary heart disease in women: results from the Nurses’ Health Study. J Am Coll Cardiol. 2009;53(11):950–8.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Kober L, Thune JJ, Nielsen JC, Haarbo J, Videbaek L, Korup E, et al. Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med. 2016;375(13):1221–30.

    Article  PubMed  Google Scholar 

  65. Witt CT, Kronborg MB, Nohr EA, Mortensen PT, Gerdes C, Jensen HK, et al. Adding the implantable cardioverter-defibrillator to cardiac resynchronization therapy is associated with improved long-term survival in ischaemic, but not in non-ischaemic cardiomyopathy. Europace. 2016;18(3):413–9.

    Article  PubMed  Google Scholar 

  66. Sacher F, Meregalli P, Veltmann C, Field ME, Solnon A, Bru P, et al. Are women with severely symptomatic brugada syndrome different from men? J Cardiovasc Electrophysiol. 2008;19(11):1181–5.

    Article  PubMed  Google Scholar 

  67. Jongman JK, Jepkes-Bruin N, Ramdat Misier AR, Beukema WP, Delnoy PP, Oude Lutttikhuis H, et al. Electrical storms in Brugada syndrome successfully treated with isoproterenol infusion and quinidine orally. Neth Hear J. 2007;15(4):151–5.

    Article  CAS  Google Scholar 

  68. Benito B, Sarkozy A, Mont L, Henkens S, Berruezo A, Tamborero D, et al. Gender differences in clinical manifestations of brugada syndrome. J Am Coll Cardiol. 2008;52(19):1567–73.

    Article  PubMed  Google Scholar 

  69. Rashba EJ, Zareba W, Moss AJ, Hall WJ, Robinson J, Locati EH, et al. Influence of pregnancy on the risk for cardiac events in patients with hereditary long QT syndrome. LQTS investigators. Circulation. 1998;97(5):451–6.

    Article  CAS  PubMed  Google Scholar 

  70. Itoh H, Crotti L, Aiba T, Spazzolini C, Denjoy I, Fressart V, et al. The genetics underlying acquired long QT syndrome: impact for genetic screening. Eur Heart J. 2016;37(18):1456–64.

    Article  PubMed  Google Scholar 

  71. Priori SG, Schwartz PJ, Napolitano C, Bloise R, Ronchetti E, Grillo M, et al. Risk stratification in the long-QT syndrome. N Engl J Med. 2003;348(19):1866–74.

    Article  PubMed  Google Scholar 

  72. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH. Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. JAMA. 1993;270(21):2590–7.

    Article  CAS  PubMed  Google Scholar 

  73. Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Wann LS, Curtis AB, et al. Management of patients with atrial fibrillation (compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS recommendations): a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(18):1916–26.

    Article  Google Scholar 

  74. Frankel DS, Tung R, Santangeli P, Tzou WS, Vaseghi M, Di Biase L, et al. Sex and catheter ablation for ventricular tachycardia: an International Ventricular Tachycardia Ablation Center Collaborative Group Study. JAMA Cardiol. 2016;1(8):938–44.

    Article  PubMed  Google Scholar 

  75. Brunner M, Olschewski M, Geibel A, Bode C, Zehender M. Long-term survival after pacemaker implantation. Prognostic importance of gender and baseline patient characteristics. Eur Heart J. 2004;25(1):88–95.

    Article  PubMed  Google Scholar 

  76. Nowak B, Misselwitz B, Expert committee ‘Pacemaker’ IoQAH, Erdogan A, Funck R, Irnich W, et al. Do gender differences exist in pacemaker implantation?—results of an obligatory external quality control program. Europace. 2010;12(2):210–5.

    Article  PubMed  Google Scholar 

  77. Russo AM, Poole JE, Mark DB, Anderson J, Hellkamp AS, Lee KL, et al. Primary prevention with defibrillator therapy in women: results from the sudden cardiac death in heart failure trial. J Cardiovasc Electrophysiol. 2008;19(7):720–4.

    Article  PubMed  Google Scholar 

  78. Zareba W, Moss AJ, Jackson Hall W, Wilber DJ, Ruskin JN, McNitt S, et al. Clinical course and implantable cardioverter defibrillator therapy in postinfarction women with severe left ventricular dysfunction. J Cardiovasc Electrophysiol. 2005;16(12):1265–70.

    Article  PubMed  Google Scholar 

  79. Russo AM, Stamato NJ, Lehmann MH, Hafley GE, Lee KL, Pieper K, et al. Influence of gender on arrhythmia characteristics and outcome in the multicenter unsustained tachycardia trial. J Cardiovasc Electrophysiol. 2004;15(9):993–8.

    Article  PubMed  Google Scholar 

  80. Santangeli P, Pelargonio G, Dello Russo A, Casella M, Bisceglia C, Bartoletti S, et al. Gender differences in clinical outcome and primary prevention defibrillator benefit in patients with severe left ventricular dysfunction: a systematic review and meta-analysis. Heart Rhythm. 2010;7(7):876–82.

    Article  PubMed  Google Scholar 

  81. MacFadden DR, Tu JV, Chong A, Austin PC, Lee DS. Evaluating sex differences in population-based utilization of implantable cardioverter-defibrillators: role of cardiac conditions and noncardiac comorbidities. Heart Rhythm. 2009;6(9):1289–96.

    Article  PubMed  Google Scholar 

  82. Curtis LH, Al-Khatib SM, Shea AM, Hammill BG, Hernandez AF, Schulman KA. Sex differences in the use of implantable cardioverter-defibrillators for primary and secondary prevention of sudden cardiac death. JAMA. 2007;298(13):1517–24.

    Article  CAS  PubMed  Google Scholar 

  83. Zusterzeel R, Selzman KA, Sanders WE, Canos DA, O’Callaghan KM, Carpenter JL, et al. Cardiac resynchronization therapy in women: US Food and Drug Administration meta-analysis of patient-level data. JAMA Intern Med. 2014;174(8):1340–8.

    Article  PubMed  Google Scholar 

  84. Cheng YJ, Zhang J, Li WJ, Lin XX, Zeng WT, Tang K, et al. More favorable response to cardiac resynchronization therapy in women than in men. Circ Arrhythm Electrophysiol. 2014;7(5):807–15.

    Article  PubMed  Google Scholar 

  85. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–200.

    Article  PubMed  Google Scholar 

  86. Roelke M, Rubinstein VJ, Kamath S, Krauser D, Ngarmukos T, Parsonnet V. Pacemaker interference with screening mammography. Pacing Clin Electrophysiol. 1999;22(7):1106–7.

    Article  CAS  PubMed  Google Scholar 

  87. Paap E, Witjes M, van Landsveld-Verhoeven C, Pijnappel RM, Maas AH, Broeders MJ. Mammography in females with an implanted medical device: impact on image quality, pain and anxiety. Br J Radiol. 2016;89(1066):20160142.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Women’s Cardiac Health Program, Radboud University Medical Center, Nijmegen, The Netherlands

    Angela H. E. M. Maas M.D., Ph.D.

  2. Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands

    Reinder Evertz M.D.

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  1. Angela H. E. M. Maas M.D., Ph.D.
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Correspondence to Angela H. E. M. Maas M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Cardiology, Women’s Cardiac Health Program, Radboud University Medical Center, Nijmegen, The Netherlands

    Angela H.E.M. Maas

  2. Director Barbra Streisand Women’s Heart Center, Linda Joy Pollin Women’s Heart Health Program, Director Preventive Cardiac Center, Cedars-Sinai, Los Angeles, USA

    C. Noel Bairey Merz

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Maas, A.H.E.M., Evertz, R. (2017). Female Aspects of Electrocardiography and Cardiac Arrhythmias. In: Maas, A., Bairey Merz, C. (eds) Manual of Gynecardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-54960-6_10

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