Primary prevention implantable cardioverter defibrillator (ICD) therapy in women-data from a multicenter French registry

Background-there are limited data describing sex specificities regarding implantable cardioverter defibrillators (icds) in the realworld european setting. methods and results-using a large multicenter cohort of consecutive patients referred for icd implantation for primary prevention (2002-2012),in ischemic and nonischemic cardiomyopathy,we examined the sex differences in subjects' characteristics and outcomes. of 5539 patients,only 837 (15.1%) were women and 53.8% received cardiac resynchronization therapy. compared to men,women presented a significantly higher proportion of nonischemic cardiomyopathy (60.2% versus 36.2%,p<0.001),wider qrs complex width (qrs >120 ms: 74.6% versus 68.5%,p=0.003),higher new york heart association functional class (=iii in 54.2%? versus 47.8%?,p=0.014),and lower prevalence of atrial fibrillation (18.7% versus 24.9%,p<0.001). during a 16 786 patient-years follow-up,overall,fewer appropriate therapies were observed in women (hazard ratio=0.59,95% ci 0.45-0.76; p<0.001). by contrast,no sex-specific interaction was observed for inappropriate shocks (odds ratio ?=0.84,95% ci 0.50-1.39,p=0.492),early complications (odds ratio=1.00,95% ci 0.75-1.32,p=0.992),and all-cause mortality (hazard ratio=0.87 95% ci 0.66-1.15,p=0.324). analysis of sex-by- cardiac resynchronization therapy interaction shows than female cardiac resynchronization therapy recipients experienced fewer appropriate therapies than men (hazard ratio=0.62,95% ci 0.50- 0.77; p<0.001) and lower mortality (hazard ratio=0.68,95% ci 0.47-0.97; p=0.034). conclusions--in our real-life registry,women account for the minority of icd recipients and presented with a different clinical profile. whereas female cardiac resynchronization therapy recipients had a lower incidence of appropriate icd therapies and all-cause death than their male counterparts,the observed rates of inappropriate shocks and early complications in all icd recipients were comparable. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.