Is there a sex bias in the selection of permanent pacemaker implantations?

ABSTRACT

OBJECTIVE: To determine whether there is a sex bias in a historical cohort of consecutive patients who underwent initial pacemaker implantation at a Canadian teaching hospital by determining whether women were less likely to receive physiological pacemakers. DESIGN: Retrospective chart review. SETTING: A Canadian, tertiary care teaching hospital. PATIENTS A total of 446 patients (192 female) had a first-time pacemaker implantation between January 1, 1990 and September 30, 1993 at Kingston General Hospital, Kingston, Ontario. RESULTS: Physiological pacemakers (dual chamber or atrial only) were implanted in 125 male patients (49.2%) and in 93 female patients (48.4%), for an absolute difference of 0.8%. In patients deemed eligible for physiological pacemaker implantation (absence of absolute or relative contraindications to physiological pacing), 63.8% of male patients and 60.6% of female patients received physiological pacemakers. Pacemakers with rate-modulation were implanted in 109 male patients (42.9%) and in 80 female patients (41.7%). These differences were not significant. CONCLUSION: No sex difference in the selection of physiological or rate-modulated permanent pacemakers was demonstrated in this study.