Gender differences in selection of pacemakers: a single-center study.

ABSTRACT

BACKGROUND: Previous studies have reported gender differences in pacemaker selection. OBJECTIVE: This study aimed to assess gender-related differences in pacemaker mode selection in patients undergoing their first implantation. METHODS: A retrospective analysis was undertaken from a single-center database of pacemaker implants during the years 2001 to 2003. Univariate and multivariate analyses were used to compare pacemaker mode selection adjusted for any significant difference between the sexes. RESULTS: A total of 274 pacemakers were implanted during the study period, 259 of which formed the basis of this study. Of the patients receiving pacemakers, 132 were male and 127 were female. The majority of patients (144 [55.6%]) had sick sinus syndrome as their indication for receiving a pacemaker, followed by complete heart block (75 [29.0%]), and second-degree or high-grade atrio-ventricular block (36 [13.9%]). Four (1.5%) patients had hypersensitive carotid sinus syndrome. The mean (SD) age of patients was 61.35 (15) years. Most (155 [59.8%]) patients were younger than age 65, and the women were significantly older than the men (P = 0.004). Atrial fibrillation (AF) was present in 53 (20.5%) patients. Dual-chamber (DDD) pacemakers were implanted in 196 (75.7%) patients, and single-chamber ventricular pacemakers in 63 (24.3%) patients. Significantly more DDD pacemakers were implanted in patients aged <65 years compared with those aged > or =65 years (P < 0.01). This difference was, however, primarily due to the higher rate of AF in the older patients versus patients aged <65 years. Although the rate of DDD implantations was observed to be higher among women (101/127 [79.5%]) compared with men (95/132 [72.0%]), the rate difference was nonsignificant, even when adjusted for the significant age difference between the sexes. Furthermore, DDD selection was independent of patients' health insurance status. CONCLUSIONS: We found no significant difference in pacemaker mode selection between male and female patients. However, we did find that patients aged <65 years were more likely to have DDD pacemakers implanted compared with older patients. This age-dependent difference was primarily due to the higher prevalence of AF in the older age group versus the younger patients. Key words pacemaker implant gender difference gender and pacemaker selection.