Arrhythmias in Female Patients: Incidence, Presentation and Management

Author:

Zeitler Emily P.12ORCID,Poole Jeanne E.3ORCID,Albert Christine M.4ORCID,Al-Khatib Sana M.5ORCID,Ali-Ahmed Fatima6,Birgersdotter-Green Ulrika7ORCID,Cha Yong-Mei6,Chung Mina K.8ORCID,Curtis Anne B.9ORCID,Hurwitz Jodie L.10ORCID,Lampert Rachel11ORCID,Sandhu Roopinder K.4,Shaik Fatima12,Sullivan Erin8,Tamirisa Kamala P.13,Santos Volgman Annabelle14ORCID,Wright Jennifer M.15ORCID,Russo Andrea M.12ORCID

Affiliation:

1. The Geisel School of Medicine at Dartmouth, Hanover, NH (E.P.Z.).

2. Division of Cardiology, Dartmouth-Hitchcock Medical Center, The Dartmouth Institute, Lebanon, NH (E.P.Z.).

3. University of Washington Medical Center, Seattle (J.E.P.).

4. Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Hospital, Los Angeles, CA (C.M.A., R.K.S.).

5. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (S.M.A.-K.).

6. Mayo Clinic, St Mary’s Campus, Rochester, MN (F.A.-A., Y.-M.C.).

7. UC San Diego Health, La Jolla, CA (U.B.-G.).

8. Cleveland Clinic, Cleveland, OH (M.K.C., E.S.).

9. Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo General Medical Center, NY (A.B.C.).

10. North Texas Heart Center, Dallas, TX (J.L.H.).

11. Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT (R.L.).

12. Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ (F.S., A.M.R.).

13. Texas Cardiac Arrhythmia Institute, Austin, TX (K.P.T.).

14. Division of Cardiology, Department of Internal Medicine, Rush University, Chicago, IL (A.S.V.).

15. Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI (J.M.W.).

Abstract

There is a growing appreciation for differences in epidemiology, treatment, and outcomes of cardiovascular conditions by sex. Historically, cardiovascular clinical trials have under-represented females, but findings have nonetheless been applied to clinical care in a sex-agnostic manner. Thus, much of the collective knowledge about sex-specific cardiovascular outcomes result from post hoc and secondary analyses. In some cases, these investigations have revealed important sex-based differences with implications for optimizing care for female patients with arrhythmias. This review explores the available evidence related to cardiac arrhythmia care among females, with emphasis on areas in which important sex differences are known or suggested. Considerations related to improving female enrollment in clinical trials as a way to establish more robust clinical evidence for the treatment of females are discussed. Areas of remaining evidence gaps are provided, and recommendations for areas of future research and specific action items are suggested. The overarching goal is to improve appreciation for sex-based differences in cardiac arrhythmia care as 1 component of a comprehensive plan to optimize arrhythmia care for all patients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine,Physiology

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