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Sex Differences in Cardiac Arrhythmias

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Abstract

Cardiac arrhythmias comprise a heterogenous group of disorders ranging from benign premature heart beats to malignant sustained ventricular tachyarrhythmias. Catheter and device-based therapies coupled with landmark clinical trials have enhanced our understanding and treatment of these disorders. Studies evaluating pathophysiology, disease course, and therapeutic options for cardiac arrhythmias have been performed in predominantly male patients. Sex differences have the potential to impact diagnostic and therapeutic interventions in a wide variety of medical conditions and cardiac arrhythmias are no exception. This chapter will review sex differences in different cardiac arrhythmias with an emphasis on clinical evaluation, treatment, and outcomes.

Keywords

  • Sex difference
  • Cardiac arrhythmia

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Fig. 14.1
Fig. 14.2

References

  1. Giraud G, Latour H, Puech P. Treatment for nodal tachycardia with procainamide: endocavitary electrocardiography study. Acta Cardiol. 1957;12:615–37.

    PubMed  CAS  Google Scholar 

  2. Taneja T, Mahnert BW, Passman R, Goldberger J, Kadish A. Effects of sex and age on electrocardiographic and cardiac electrophysiological properties in adults. Pacing Clin Electrophysiol. 2001;24:16–21.

    PubMed  CrossRef  CAS  Google Scholar 

  3. Soliman EZ, Alonso A, Misialek JR, Jain A, Watson KE, Lloyd-Jones DM, Lima J, Shea S, Burke GL, Heckbert SR. Reference ranges of PR duration and P-wave indices in individuals free of cardiovascular disease: the multi-ethnic study of atherosclerosis (MESA). J Electrocardiol. 2013;46:702–6.

    PubMed  CrossRef  Google Scholar 

  4. 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;79:178–81.

    PubMed  CrossRef  CAS  Google Scholar 

  5. Surawicz B, Parikh SR. Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age. J Am Coll Cardiol. 2002;40:1870–6.

    PubMed  CrossRef  Google Scholar 

  6. Vicente J, Johannesen L, Galeotti L, Strauss DG. Mechanisms of sex and age differences in ventricular repolarization in humans. Am Heart J. 2014;168:749–56.

    PubMed  CrossRef  Google Scholar 

  7. Lee WC, Lamas GA, Balu S, Spalding J, Wang Q, Pashos CL. Direct treatment cost of atrial fibrillation in the elderly American population: a Medicare perspective. J Med Econ. 2008;11:281–98.

    PubMed  CrossRef  Google Scholar 

  8. Kim MH, Johnston SS, Chu BC, Dalal MR, Schulman KL. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4:313–20.

    PubMed  CrossRef  Google Scholar 

  9. Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. Prevalence of atrial fibrillation in elderly subjects (the cardiovascular health study). Am J Cardiol. 1994;74:236–41.

    PubMed  CrossRef  CAS  Google Scholar 

  10. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TS. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:119–25.

    PubMed  CrossRef  Google Scholar 

  11. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, D'Agostino RB, Massaro JM, Beiser A, Wolf PA, Benjamin EJ. Lifetime risk for development of atrial fibrillation: the Framingham heart study. Circulation. 2004;110:1042–6.

    PubMed  CrossRef  Google Scholar 

  12. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, Gillum RF, Kim YH, JH MA Jr, Zheng ZJ, Forouzanfar MH, Naghavi M, Mensah GA, Ezzati M, Murray CJ. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study. Circulation. 2014;129:837–47.

    PubMed  CrossRef  Google Scholar 

  13. Lip GY, Laroche C, Boriani G, Cimaglia P, Dan GA, Santini M, Kalarus Z, Rasmussen LH, Popescu MI, Tica O, Hellum CF, Mortensen B, Tavazzi L, Maggioni AP. Sex-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Observational Research Programme Pilot survey on Atrial Fibrillation. Europace. 2015;17:24–31.

    PubMed  CrossRef  Google Scholar 

  14. Ball J, Carrington MJ, Wood KA, Stewart S. Women versus men with chronic atrial fibrillation: insights from the Standard versus Atrial Fibrillation specific management study (SAFETY). PLoS One. 2013;8:e65795.

    PubMed  PubMed Central  CrossRef  CAS  Google Scholar 

  15. Roten L, Rimoldi SF, Schwick N, Sakata T, Heimgartner C, Fuhrer J, Delacretaz E, Tanner H. Gender differences in patients referred for atrial fibrillation management to a tertiary center. Pacing Clin Electrophysiol. 2009;32:622–6.

    PubMed  CrossRef  Google Scholar 

  16. Flaker GC, Fletcher KA, Rothbart RM, Halperin JL, Hart RG. Clinical and echocardiographic features of intermittent atrial fibrillation that predict recurrent atrial fibrillation. Stroke Prevention In Atrial Fibrillation (SPAF) investigators. Am J Cardiol. 1995;76:355–8.

    PubMed  CrossRef  CAS  Google Scholar 

  17. Proietti M, Raparelli V, Basili S, Olshansky B, Lip GY. Relation of female sex to left atrial diameter and cardiovascular death in atrial fibrillation: The AFFIRM Trial. Int J Cardiol. 2016;207:258–63.

    PubMed  CrossRef  Google Scholar 

  18. Tsai WC, Chen YC, Lin YK, Chen SA, Chen YJ. Sex differences in the electrophysiological characteristics of pulmonary veins and left atrium and their clinical implication in atrial fibrillation. Circ Arrhythm Electrophysiol. 2011;4:550–9.

    PubMed  CrossRef  CAS  Google Scholar 

  19. Magnani JW, Moser CB, Murabito JM, Sullivan LM, Wang N, Ellinor PT, Vasan RS, Benjamin EJ, Coviello AD. Association of sex hormones, aging, and atrial fibrillation in men: the framingham heart study. Circ Arrhythm Electrophysiol. 2014;7:307–12.

    PubMed  PubMed Central  CrossRef  CAS  Google Scholar 

  20. Sposato LA, Cipriano LE, Saposnik G, Vargas ER, Riccio PM, Hachinski V. Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2015;14:377–87.

    PubMed  CrossRef  Google Scholar 

  21. Fang MC, Singer DE, Chang Y, Hylek EM, Henault LE, Jensvold NG, Go AS. Gender differences in the risk of ischemic stroke and peripheral embolism in atrial fibrillation: the AnTicoagulation and Risk factors in Atrial fibrillation (ATRIA) study. Circulation. 2005;112:1687–91.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  22. Andersson T, Magnuson A, Bryngelsson IL, Frobert O, Henriksson KM, Edvardsson N, Poci D. 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;177:91–9.

    PubMed  CrossRef  Google Scholar 

  23. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130:2071–104.

    PubMed  CrossRef  Google Scholar 

  24. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P, Agewall S, Camm J, Baron Esquivias G, Budts W, Carerj S, Casselman F, Coca A, De Caterina R, Deftereos S, Dobrev D, Ferro JM, Filippatos G, Fitzsimons D, Gorenek B, Guenoun M, Hohnloser SH, Kolh P, Lip GY, Manolis A, McMurray J, Ponikowski P, Rosenhek R, Ruschitzka F, Savelieva I, Sharma S, Suwalski P, Tamargo JL, Taylor CJ, Van Gelder IC, Voors AA, Windecker S, Zamorano JL, Zeppenfeld K. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893–962.

    PubMed  CrossRef  Google Scholar 

  25. Humphries KH, Kerr CR, Connolly SJ, Klein G, Boone JA, Green M, Sheldon R, Talajic M, Dorian P, Newman D. New-onset atrial fibrillation: sex differences in presentation, treatment, and outcome. Circulation. 2001;103:2365–70.

    PubMed  CrossRef  CAS  Google Scholar 

  26. Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin: Stroke Prevention in Atrial Fibrillation III Study. The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. JAMA. 1998;279:1273–7.

    Google Scholar 

  27. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955–62.

    PubMed  CrossRef  CAS  Google Scholar 

  28. Lip GY, Andreotti F, Fauchier L, Huber K, Hylek E, Knight E, Lane D, Levi M, Marin F, Palareti G, Kirchhof P. Bleeding risk assessment and management in atrial fibrillation patients. Executive summary of a position document from the European heart rhythm association [EHRA], endorsed by the European Society of Cardiology [ESC] working group on thrombosis. Thromb Haemost. 2011;106:997–1011.

    PubMed  CrossRef  CAS  Google Scholar 

  29. Senoo K, Lip GY. Female sex, time in therapeutic range, and clinical outcomes in atrial fibrillation patients taking warfarin. Stroke. 2016;47:1665–8.

    PubMed  CrossRef  CAS  Google Scholar 

  30. Holmes DR Jr, Doshi SK, Kar S, Price MJ, Sanchez JM, Sievert H, Valderrabano M, Reddy VY. Left atrial appendage closure as an alternative to warfarin for stroke prevention in atrial fibrillation: a patient-level meta-analysis. J Am Coll Cardiol. 2015;65:2614–23.

    PubMed  CrossRef  Google Scholar 

  31. Dagres N, Nieuwlaat R, Vardas PE, Andresen D, Levy S, Cobbe S, Kremastinos DT, Breithardt G, Cokkinos DV, Crijns HJ. 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;49:572–7.

    PubMed  CrossRef  Google Scholar 

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

    PubMed  CrossRef  CAS  Google Scholar 

  33. Torp-Pedersen C, Moller M, Bloch-Thomsen PE, Kober L, Sandoe E, Egstrup K, Agner E, Carlsen J, Videbaek J, Marchant B, Camm AJ. Dofetilide in patients with congestive heart failure and left ventricular dysfunction. Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group. N Engl J Med. 1999;341:857–65.

    PubMed  CrossRef  CAS  Google Scholar 

  34. Gowda RM, Khan IA, Punukollu G, Vasavada BC, Sacchi TJ, Wilbur SL. Female preponderance in ibutilide-induced torsade de pointes. Int J Cardiol. 2004;95:219–22.

    PubMed  CrossRef  Google Scholar 

  35. 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;270:2590–7.

    PubMed  CrossRef  CAS  Google Scholar 

  36. Rodriguez I, Kilborn MJ, Liu XK, Pezzullo JC, Woosley RL, Drug-induced QT. Prolongation in women during the menstrual cycle. JAMA. 2001;285:1322–6.

    PubMed  CrossRef  CAS  Google Scholar 

  37. Forleo GB, Tondo C, De Luca L, Dello Russo A, Casella M, De Sanctis V, Clementi F, Fagundes RL, Leo R, Romeo F, Mantica M. Gender-related differences in catheter ablation of atrial fibrillation. Europace. 2007;9:613–20.

    PubMed  CrossRef  Google Scholar 

  38. Zhang XD, Tan HW, Gu J, Jiang WF, Zhao L, Wang YL, Liu YG, Zhou L, JN G, Liu X. Efficacy and safety of catheter ablation for long-standing persistent atrial fibrillation in women. Pacing Clin Electrophysiol. 2013;36:1236–44.

    PubMed  CrossRef  Google Scholar 

  39. Zylla MM, Brachmann J, Lewalter T, Hoffmann E, Kuck KH, Andresen D, Willems S, Eckardt L, Tebbenjohanns J, Spitzer SG, Schumacher B, Hochadel M, Senges J, Katus HA, Thomas D. Sex-related outcome of atrial fibrillation ablation: Insights from the German Ablation Registry. Heart Rhythm. 2016;13:1837–44.

    PubMed  CrossRef  Google Scholar 

  40. Kuck KH, Brugada J, Furnkranz A, Metzner A, Ouyang F, Chun KR, Elvan A, Arentz T, Bestehorn K, Pocock SJ, Albenque JP, Tondo C. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med. 2016;374:2235–45.

    PubMed  CrossRef  Google Scholar 

  41. Brembilla-Perrot B, Huttin O, Manenti V, Benichou M, Sellal JM, Zinzius PY, Beurrier D, Schwartz J, Laporte F, de Chillou C, Andronache M, Cismaru G, Pauriah M, Selton O, Louis P, de la Terrier Chaise A. Sex-related differences in peri- and post-ablation clinical data for patients with atrial flutter. Int J Cardiol. 2013;168:1951–4.

    PubMed  CrossRef  CAS  Google Scholar 

  42. Hoyt H, Bhonsale A, Chilukuri K, Alhumaid F, Needleman M, Edwards D, Govil A, Nazarian S, Cheng A, Henrikson CA, Sinha S, Marine JE, Berger R, Calkins H, Spragg DD. Complications arising from catheter ablation of atrial fibrillation: temporal trends and predictors. Heart Rhythm. 2011;8:1869–74.

    PubMed  CrossRef  Google Scholar 

  43. Shah SV, Kruse J, Andrei AC, Li Z, Malaisrie SC, Knight BP, Passman RS, PM MC. Gender differences in outcomes after surgical ablation of atrial fibrillation. J Thoracic Cardiovasc Surg. 2016;151:391–8.e2.

    CrossRef  Google Scholar 

  44. Wu D, Denes P. Mechanisms of paroxysmal supraventricular tachycardia. Arch Intern Med. 1975;135:437–42.

    PubMed  CrossRef  CAS  Google Scholar 

  45. Deneke T, Muller P, Lawo T, Lemke B, Horlitz M, Calcum B, Bosche LI, Mugge A, Grewe PH. Gender differences in onset of symptoms in AV nodal re-entrant and accessory pathway-mediated re-entrant tachycardia. Herzschrittmacherther Elektrophysiol. 2009;20:33–8.

    PubMed  CrossRef  CAS  Google Scholar 

  46. Suenari K, YF H, Tsao HM, Tai CT, Chiang CE, Lin YJ, Chang SL, Lo LW, Ta-Chuan T, Lee PC, Tung NH, Huang SY, TJ W, Chen SA. Gender differences in the clinical characteristics and atrioventricular nodal conduction properties in patients with atrioventricular nodal reentrant tachycardia. J Cardiovasc Electrophysiol. 2010;21:1114–9.

    PubMed  CrossRef  Google Scholar 

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

    PubMed  CrossRef  Google Scholar 

  48. Rosano GM, Leonardo F, Sarrel PM, Beale CM, De Luca F, Collins P. Cyclical variation in paroxysmal supraventricular tachycardia in women. Lancet. 1996;347:786–8.

    PubMed  CrossRef  CAS  Google Scholar 

  49. Myerburg RJ, Cox MM, Interian A Jr, Mitrani R, Girgis I, Dylewski J, Castellanos A. Cycling of inducibility of paroxysmal supraventricular tachycardia in women and its implications for timing of electrophysiologic procedures. Am J Cardiol. 1999;83:1049–54.

    PubMed  CrossRef  CAS  Google Scholar 

  50. Farkowski MM, Pytkowski M, Maciag A, Golicki D, Wood KA, Kowalik I, Kuteszko R, Szwed H. Gender-related differences in outcomes and resource utilization in patients undergoing radiofrequency ablation of supraventricular tachycardia: results from Patients’ Perspective on Radiofrequency Catheter Ablation of AVRT and AVNRT Study. Europace. 2014;16:1821–7.

    PubMed  CrossRef  Google Scholar 

  51. Rodriguez LM, de Chillou C, Schlapfer J, Metzger J, Baiyan X, van den Dool A, Smeets JL, Wellens HJ. Age at onset and gender of patients with different types of supraventricular tachycardias. Am J Cardiol. 1992;70:1213–5.

    PubMed  CrossRef  CAS  Google Scholar 

  52. Hsu JC, Tanel RE, Lee BK, Scheinman MM, Badhwar N, Lee RJ, Tseng ZH, Olgin JE, Marcus GM. Differences in accessory pathway location by sex and race. Heart Rhythm. 2010;7:52–6.

    PubMed  CrossRef  Google Scholar 

  53. Liu S, Yuan S, Hertervig E, Kongstad O, Olsson SB. Gender and atrioventricular conduction properties of patients with symptomatic atrioventricular nodal reentrant tachycardia and Wolff-Parkinson-white syndrome. J Electrocardiol. 2001;34:295–301.

    PubMed  CrossRef  CAS  Google Scholar 

  54. Kammeraad JA, Balaji S, Oliver RP, Chugh SS, Halperin BD, Kron J, McAnulty JH. Nonautomatic focal atrial tachycardia: characterization and ablation of a poorly understood arrhythmia in 38 patients. Pacing Clin Electrophysiol. 2003;26:736–42.

    PubMed  CrossRef  Google Scholar 

  55. YF H, Huang JL, TJ W, Higa S, Shih CM, Tai CT, Lin YJ, Chang SL, Lo LW, Ta-Chuan T, Chang CJ, Tsai WC, Lee PC, Tsao HM, Ishigaki S, Oyakawa A, Chen SA. Gender differences of electrophysiological characteristics in focal atrial tachycardia. Am J Cardiol. 2009;104:97–100.

    CrossRef  Google Scholar 

  56. Lerman BB, Stein KM, Markowitz SM. Mechanisms of idiopathic left ventricular tachycardia. J Cardiovasc Electrophysiol. 1997;8:571–83.

    PubMed  CrossRef  CAS  Google Scholar 

  57. Nakagawa M, Takahashi N, Nobe S, Ichinose M, Ooie T, Yufu F, Shigematsu S, Hara M, Yonemochi H, Saikawa T. Gender differences in various types of idiopathic ventricular tachycardia. J Cardiovasc Electrophysiol. 2002;13:633–8.

    PubMed  CrossRef  Google Scholar 

  58. Marchlinski FE, Deely MP, Zado ES. Sex-specific triggers for right ventricular outflow tract tachycardia. Am Heart J. 2000;139:1009–13.

    PubMed  CrossRef  CAS  Google Scholar 

  59. Liu Y, Fang Z, Yang B, Kojodjojo P, Chen H, Ju W, Cao K, Chen M, Zhang F. Catheter ablation of fascicular ventricular tachycardia: long-term clinical outcomes and mechanisms of recurrence. Circ Arrhythm Electrophysiol. 2015;8:1443–51.

    PubMed  PubMed Central  CAS  Google Scholar 

  60. Liu Q, Shehata M, Jiang R, Yu L, Chen S, Zhu J, Ehdaie A, Sovari AA, Cingolani E, Chugh SS, Jiang C, Wang X. Macroreentrant loop in ventricular tachycardia from the left posterior fascicle: new implications for mapping and ablation. Circ Arrhythm Electrophysiol. 2016;9:e004272.

    PubMed  CrossRef  Google Scholar 

  61. Nogami A, Naito S, Tada H, Oshima S, Taniguchi K, Aonuma K, Iesaka Y. Verapamil-sensitive left anterior fascicular ventricular tachycardia: results of radiofrequency ablation in six patients. J Cardiovasc Electrophysiol. 1998;9:1269–78.

    PubMed  CrossRef  CAS  Google Scholar 

  62. Lee GK, Klarich KW, Grogan M, Cha YM. Premature ventricular contraction-induced cardiomyopathy: a treatable condition. Circ Arrhythm Electrophysiol. 2012;5:229–36.

    PubMed  CrossRef  Google Scholar 

  63. Chen YJ, Lee SH, Hsieh MH, Hsiao CJ, Yu WC, Chiou CW, Chen SA. Effects of 17beta-estradiol on tachycardia-induced changes of atrial refractoriness and cisapride-induced ventricular arrhythmia. J Cardiovasc Electrophysiol. 1999;10:587–98.

    PubMed  CrossRef  CAS  Google Scholar 

  64. James AF, Arberry LA, Hancox JC. Gender-related differences in ventricular myocyte repolarization in the guinea pig. Basic Res Cardiol. 2004;99:183–92.

    PubMed  CrossRef  CAS  Google Scholar 

  65. Gaborit N, Varro A, Le Bouter S, Szuts V, Escande D, Nattel S, Demolombe S. Gender-related differences in ion-channel and transporter subunit expression in non-diseased human hearts. J Mol Cell Cardiol. 2010;49:639–46.

    PubMed  CrossRef  CAS  Google Scholar 

  66. McAloon CJ, Boylan LM, Hamborg T, Stallard N, Osman F, Lim PB, Hayat SA. The changing face of cardiovascular disease 2000-2012: An analysis of the world health organisation global health estimates data. Int J Cardiol. 2016;224:256–64.

    PubMed  CrossRef  Google Scholar 

  67. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, Daubert JP, Higgins SL, Brown MW, Andrews ML. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877–83.

    PubMed  CrossRef  Google Scholar 

  68. Russo AM, Stamato NJ, Lehmann MH, Hafley GE, Lee KL, Pieper K, Buxton AE. Influence of gender on arrhythmia characteristics and outcome in the Multicenter UnSustained Tachycardia Trial. J Cardiovasc Electrophysiol. 2004;15:993–8.

    PubMed  CrossRef  Google Scholar 

  69. Lampert R, McPherson CA, Clancy JF, Caulin-Glaser TL, Rosenfeld LE, Batsford WP. Gender differences in ventricular arrhythmia recurrence in patients with coronary artery disease and implantable cardioverter-defibrillators. J Am Coll Cardiol. 2004;43:2293–9.

    PubMed  CrossRef  Google Scholar 

  70. Frankel DS, Tung R, Santangeli P, Tzou WS, Vaseghi M, Di Biase L, Nagashima K, Tedrow U, Bunch TJ, Tholakanahalli VN, Dendi R, Reddy M, Lakkireddy D, Dickfeld T, Weiss JP, Mathuria N, Vergara P, Patel M, Nakahara S, Vakil K, Sauer WH, Callans DJ, Natale A, Stevenson WG, Della Bella P, Shivkumar K, Marchlinski FE. Sex and catheter ablation for ventricular tachycardia: an international ventricular tachycardia ablation Center collaborative group study. JAMA Cardiol. 2016;1:938–44.

    PubMed  CrossRef  Google Scholar 

  71. Baldinger SH, Kumar S, Romero J, Fujii A, Epstein LM, Michaud GF, John R, Tedrow UB, Stevenson WG. A Comparison of women and men undergoing catheter ablation for sustained monomorphic ventricular tachycardia. J Cardiovasc Electrophysiol. 2017;28(2):201–7.

    PubMed  CrossRef  Google Scholar 

  72. van Rijsingen IA, Nannenberg EA, Arbustini E, Elliott PM, Mogensen J, Hermans-van Ast JF, van der Kooi AJ, van Tintelen JP, van den Berg MP, Grasso M, Serio A, Jenkins S, Rowland C, Richard P, Wilde AA, Perrot A, Pankuweit S, Zwinderman AH, Charron P, Christiaans I, Pinto YM. Gender-specific differences in major cardiac events and mortality in lamin A/C mutation carriers. Eur J Heart Fail. 2013;15:376–84.

    PubMed  CrossRef  CAS  Google Scholar 

  73. Takahashi A, Shiga T, Shoda M, Tanizaki K, Manaka T, Ejima K, Kasanuki H, Hagiwara N. Gender difference in arrhythmic occurrences in patients with nonischemic dilated cardiomyopathy and implantable cardioverter-defibrillator. Heart Vessel. 2010;25:150–4.

    CrossRef  Google Scholar 

  74. Muser D, Santangeli P, Castro SA, Pathak RK, Liang JJ, Hayashi T, Magnani S, Garcia FC, Hutchinson MD, Supple GG, Frankel DS, Riley MP, Lin D, Schaller RD, Dixit S, Zado ES, Callans DJ, Marchlinski FE. Long-term outcome after catheter ablation of ventricular tachycardia in patients with nonischemic dilated cardiomyopathy. Circ Arrhythm Electrophysiol. 2016;9:e004328.

    PubMed  CrossRef  CAS  Google Scholar 

  75. Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, Dubourg O, Kuhl U, Maisch B, McKenna WJ, Monserrat L, Pankuweit S, Rapezzi C, Seferovic P, Tavazzi L, Keren A. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29:270–6.

    PubMed  CrossRef  Google Scholar 

  76. Mazzanti A, Ng K, Faragli A, Maragna R, Chiodaroli E, Orphanou N, Monteforte N, Memmi M, Gambelli P, Novelli V, Bloise R, Catalano O, Moro G, Tibollo V, Morini M, Bellazzi R, Napolitano C, Bagnardi V, Priori SG. Arrhythmogenic right ventricular cardiomyopathy: clinical course and predictors of arrhythmic risk. J Am Coll Cardiol. 2016;68:2540–50.

    PubMed  CrossRef  Google Scholar 

  77. Corrado D, Wichter T, Link MS, Hauer RN, Marchlinski FE, Anastasakis A, Bauce B, Basso C, Brunckhorst C, Tsatsopoulou A, Tandri H, Paul M, Schmied C, Pelliccia A, Duru F, Protonotarios N, Estes NM 3rd, McKenna WJ, Thiene G, Marcus FI, Calkins H. Treatment of arrhythmogenic right ventricular cardiomyopathy/dysplasia: an International Task Force Consensus Statement. Circulation. 2015;132:441–53.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  78. Hillerdal G, Nou E, Osterman K, Schmekel B. Sarcoidosis: epidemiology and prognosis. A 15-year European study. Am Rev Respir Dis. 1984;130:29–32.

    PubMed  CAS  Google Scholar 

  79. Muser D, Santangeli P, Pathak RK, Castro SA, Liang JJ, Magnani S, Hayashi T, Garcia FC, Hutchinson MD, Supple GE, Frankel DS, Riley MP, Lin D, Schaller RD, Desjardins B, Dixit S, Callans DJ, Zado ES, Marchlinski FE. Long-term outcomes of catheter ablation of ventricular tachycardia in patients with cardiac Sarcoidosis. Circ Arrhythm Electrophysiol. 2016;9:e004333.

    PubMed  CrossRef  Google Scholar 

  80. Kumar S, Barbhaiya C, Nagashima K, Choi EK, Epstein LM, John RM, Maytin M, Albert CM, Miller AL, Koplan BA, Michaud GF, Tedrow UB, Stevenson WG. Ventricular tachycardia in cardiac sarcoidosis: characterization of ventricular substrate and outcomes of catheter ablation. Circ Arrhythm Electrophysiol. 2015;8:87–93.

    PubMed  CrossRef  Google Scholar 

  81. Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS. Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol. 2014;64:83–99.

    PubMed  CrossRef  Google Scholar 

  82. Olivotto I, Maron MS, Adabag AS, Casey SA, Vargiu D, Link MS, Udelson JE, Cecchi F, Maron BJ. Gender-related differences in the clinical presentation and outcome of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2005;46:480–7.

    PubMed  CrossRef  Google Scholar 

  83. Lehmann MH, Timothy KW, Frankovich D, Fromm BS, Keating M, Locati EH, Taggart RT, Towbin JA, Moss AJ, Schwartz PJ, Vincent GM. Age-gender influence on the rate-corrected QT interval and the QT-heart rate relation in families with genotypically characterized long QT syndrome. J Am Coll Cardiol. 1997;29:93–9.

    PubMed  CrossRef  CAS  Google Scholar 

  84. Locati EH, Zareba W, Moss AJ, Schwartz PJ, Vincent GM, Lehmann MH, Towbin JA, Priori SG, Napolitano C, Robinson JL, Andrews M, Timothy K, Hall WJ. Age- and sex-related differences in clinical manifestations in patients with congenital long-QT syndrome: findings from the International LQTS Registry. Circulation. 1998;97:2237–44.

    PubMed  CrossRef  CAS  Google Scholar 

  85. Rautaharju PM, Zhou SH, Wong S, Calhoun HP, Berenson GS, Prineas R, Davignon A. Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol. 1992;8:690–5.

    PubMed  CAS  Google Scholar 

  86. Benito B, Sarkozy A, Mont L, Henkens S, Berruezo A, Tamborero D, Arzamendi D, Berne P, Brugada R, Brugada P, Brugada J. Gender differences in clinical manifestations of Brugada syndrome. J Am Coll Cardiol. 2008;52:1567–73.

    PubMed  CrossRef  Google Scholar 

  87. Di Diego JM, Cordeiro JM, Goodrow RJ, Fish JM, Zygmunt AC, Perez GJ, Scornik FS, Antzelevitch C. Ionic and cellular basis for the predominance of the Brugada syndrome phenotype in males. Circulation. 2002;106:2004–11.

    PubMed  CrossRef  Google Scholar 

  88. Mohamed U, Napolitano C, Priori SG. Molecular and electrophysiological bases of catecholaminergic polymorphic ventricular tachycardia. J Cardiovasc Electrophysiol. 2007;18:791–7.

    PubMed  CrossRef  Google Scholar 

  89. Priori SG, Napolitano C, Memmi M, Colombi B, Drago F, Gasparini M, DeSimone L, Coltorti F, Bloise R, Keegan R, Cruz Filho FE, Vignati G, Benatar A, DeLogu A. Clinical and molecular characterization of patients with catecholaminergic polymorphic ventricular tachycardia. Circulation. 2002;106:69–74.

    PubMed  CrossRef  CAS  Google Scholar 

  90. Lehnart SE, Wehrens XH, Laitinen PJ, Reiken SR, Deng SX, Cheng Z, Landry DW, Kontula K, Swan H, Marks AR. Sudden death in familial polymorphic ventricular tachycardia associated with calcium release channel (ryanodine receptor) leak. Circulation. 2004;109:3208–14.

    PubMed  CrossRef  CAS  Google Scholar 

  91. Tester DJ, Arya P, Will M, Haglund CM, Farley AL, Makielski JC, Ackerman MJ. Genotypic heterogeneity and phenotypic mimicry among unrelated patients referred for catecholaminergic polymorphic ventricular tachycardia genetic testing. Heart Rhythm. 2006;3:800–5.

    PubMed  CrossRef  Google Scholar 

  92. Patel C, Yan GX, Antzelevitch C. Short QT syndrome: from bench to bedside. Circ Arrhythm Electrophysiol. 2010;3:401–8.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  93. Dhutia H, Malhotra A, Parpia S, Gabus V, Finocchiaro G, Mellor G, Merghani A, Millar L, Narain R, Sheikh N, Behr ER, Papadakis M, Sharma S. The prevalence and significance of a short QT interval in 18,825 low-risk individuals including athletes. Br J Sports Med. 2016;50:124–9.

    PubMed  CrossRef  Google Scholar 

  94. Tikkanen JT, Anttonen O, Junttila MJ, Aro AL, Kerola T, Rissanen HA, Reunanen A, Huikuri HV. Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med. 2009;361:2529–37.

    PubMed  CrossRef  CAS  Google Scholar 

  95. Haissaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquie JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O'Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clementy J. Sudden cardiac arrest associated with early repolarization. New Engl J Med. 2008;358:2016–23.

    PubMed  CrossRef  CAS  Google Scholar 

  96. Rosso R, Kogan E, Belhassen B, Rozovski U, Scheinman MM, Zeltser D, Halkin A, Steinvil A, Heller K, Glikson M, Katz A, Viskin S. J-point elevation in survivors of primary ventricular fibrillation and matched control subjects: incidence and clinical significance. J Am Coll Cardiol. 2008;52:1231–8.

    PubMed  CrossRef  Google Scholar 

  97. Noseworthy PA, Tikkanen JT, Porthan K, Oikarinen L, Pietila A, Harald K, Peloso GM, Merchant FM, Jula A, Vaananen H, Hwang SJ, O’Donnell CJ, Salomaa V, Newton-Cheh C, Huikuri HV. The early repolarization pattern in the general population: clinical correlates and heritability. J Am Coll Cardiol. 2011;57:2284–9.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  98. 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;298:1517–24.

    PubMed  CrossRef  CAS  Google Scholar 

  99. Ghanbari H, Dalloul G, Hasan R, Daccarett M, Saba S, David S, Machado C. Effectiveness of implantable cardioverter-defibrillators for the primary prevention of sudden cardiac death in women with advanced heart failure: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169:1500–6.

    PubMed  CrossRef  Google Scholar 

  100. Santangeli P, Pelargonio G, Dello Russo A, Casella M, Bisceglia C, Bartoletti S, Santarelli P, Di Biase L, Natale A. 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;7:876–82.

    PubMed  CrossRef  Google Scholar 

  101. Kober L, Thune JJ, Nielsen JC, Haarbo J, Videbaek L, Korup E, Jensen G, Hildebrandt P, Steffensen FH, Bruun NE, Eiskjaer H, Brandes A, Thogersen AM, Gustafsson F, Egstrup K, Videbaek R, Hassager C, Svendsen JH, Hofsten DE, Torp-Pedersen C, Pehrson S. Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med. 2016;375:1221–30.

    PubMed  CrossRef  Google Scholar 

  102. Kannel WB, Schatzkin A. Sudden death: lessons from subsets in population studies. J Am Coll Cardiol. 1985;5:141b–9b.

    PubMed  CrossRef  CAS  Google Scholar 

  103. Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B, Ilias N, Vickers C, Dogra V, Daya M, Kron J, Zheng ZJ, Mensah G, McAnulty J. Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. J Am Coll Cardiol. 2004;44:1268–75.

    PubMed  CrossRef  Google Scholar 

  104. Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, McAnulty JH, Gunson K, Jui J, Chugh SS. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon sudden unexpected death study. J Am Coll Cardiol. 2006;47:1161–6.

    PubMed  CrossRef  Google Scholar 

  105. Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK. Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000. JAMA. 2002;288:3008–13.

    PubMed  CrossRef  Google Scholar 

  106. Kuisma M, Repo J, Alaspaa A. The incidence of out-of-hospital ventricular fibrillation in Helsinki, Finland, from 1994 to 1999. Lancet. 2001;358:473–4.

    PubMed  CrossRef  CAS  Google Scholar 

  107. Teodorescu C, Reinier K, Dervan C, Uy-Evanado A, Samara M, Mariani R, Gunson K, Jui J, Chugh SS. Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study. Circulation. 2010;122:2116–22.

    PubMed  CrossRef  Google Scholar 

  108. Albert CM, McGovern BA, Newell JB, Ruskin JN. Sex differences in cardiac arrest survivors. Circulation. 1996;93:1170–6.

    PubMed  CrossRef  CAS  Google Scholar 

  109. Wissenberg M, Hansen CM, Folke F, Lippert FK, Weeke P, Karlsson L, Rajan S, Sondergaard KB, Kragholm K, Christensen EF, Nielsen SL, Kober L, Gislason GH, Torp-Pedersen C. Survival after out-of-hospital cardiac arrest in relation to sex: a nationwide registry-based study. Resuscitation. 2014;85:1212–8.

    PubMed  CrossRef  Google Scholar 

  110. Teodorescu C, Reinier K, Uy-Evanado A, Ayala J, Mariani R, Wittwer L, Gunson K, Jui J, Chugh SS. Survival advantage from ventricular fibrillation and pulseless electrical activity in women compared to men: the Oregon sudden unexpected death study. J Int Card Electrophysiol. 2012;34:219–25.

    CrossRef  Google Scholar 

  111. Chugh SS, Chung K, Zheng ZJ, John B, Titus JL. Cardiac pathologic findings reveal a high rate of sudden cardiac death of undetermined etiology in younger women. Am Heart J. 2003;146:635–9.

    PubMed  CrossRef  Google Scholar 

  112. Marijon E, Uy-Evanado A, Dumas F, Karam N, Reinier K, Teodorescu C, Narayanan K, Gunson K, Jui J, Jouven X, Chugh SS. Warning symptoms are associated with survival from sudden cardiac arrest. Ann Intern Med. 2016;164:23–9.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  113. Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am Heart J. 1986;111:383–90.

    PubMed  CrossRef  CAS  Google Scholar 

  114. Chugh SS, Uy-Evanado A, Teodorescu C, Reinier K, Mariani R, Gunson K, Jui J. Women have a lower prevalence of structural heart disease as a precursor to sudden cardiac arrest: the Ore-SUDS (Oregon Sudden Unexpected Death Study). J Am Coll Cardiol. 2009;54:2006–11.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  115. 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;25:88–95.

    PubMed  CrossRef  Google Scholar 

  116. Schuppel R, Buchele G, Batz L, Koenig W. Sex differences in selection of pacemakers: retrospective observational study. BMJ. 1998;316:1492–5.

    PubMed  PubMed Central  CrossRef  CAS  Google Scholar 

  117. Nowak B, Misselwitz B, Erdogan A, Funck R, Irnich W, Israel CW, Olbrich HG, Schmidt H, Sperzel J, Zegelman M. Do gender differences exist in pacemaker implantation?—results of an obligatory external quality control program. Europace. 2010;12:210–5.

    PubMed  CrossRef  Google Scholar 

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Ehdaie, A., Chugh, S.S. (2018). Sex Differences in Cardiac Arrhythmias. In: Mehta, J., McSweeney, J. (eds) Gender Differences in the Pathogenesis and Management of Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-71135-5_14

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