Sex Disparities in the Choice of Cardiac Resynchronization Therapy Device: An Analysis of Trends, Predictors, and Outcomes

AbstractBackground There is limited evidence on the influence of sex decision to implant a cardiac resynchronization therapy device with pacemaker (CRT-P) or defibrillator (CRT-D) and existence sex-dependent differences in complications that may affect this decision. Methods All patients undergoing de novo CRT implantation (2004-2014) United States National Inpatient Sample were included stratified by type (CRT-P CRT-D). Multivariable logistic regression models conducted assess association female receipt CRT-D periprocedural complications. Results Out 400,823 weighted procedural records, overall percentages women CRT-P implantations 41.5% 27.8%, respectively, these increased compared men over study period. Women less likely receive (odds ratio 0.66, 95% confidence interval 0.64-0.67), trend remained stable throughout period (P = 0.06). Furthermore, men, associated odds procedure-related (bleeding, thoracic, cardiac) group but not group. Factors such as atrial fibrillation, malignancies, renal failure, advanced age (> 60 years), admission nonurban/small hospitals favoured CRT-D, whereas history ischemic heart disease, arrest ,or ventricular arrhythmias CRT-P. Conclusions persistently reduced an 11-year This identifies important factors predict choice offered States.