MALIGNANT SUSTAINED VENTRICULAR TACHYARRHYTHMIAS IN WOMEN - CHARACTERISTICS AND OUTCOME OF TREATMENT WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR

Implantable Defibrillators in Women. Clinical rhythm, heart disease, e jection fraction, defibrillation threshold, recurrent arrhythmias, and mortality were compared in 268 consecutive recipients (213 men and 55 women) of their first implantable cardioverter defibrillator for life -threatening ventricular tachycardia or fibrillation. Women were young er than men, less likely to have structural heart disease, and more li kely to have clinical ventricular fibrillation, a higher ejection frac tion, and a lower defibrillation threshold. Complications of defibrill ator placement were similar in both sexes. Unadjusted survival tended to be higher in women than in men (97% vs 90%, respectively, at 2 year s, P = 0.08), largely due to fewer deaths front noncardiac causes or c ardiac causes other than arrhythmia (P = 0.09). Women also tended to b e at lower, albeit still substantial, risk for recurrent arrhythmias d uring follow-up (37% vs 52% in men at 2 years, P = 0.11). After adjust ment for baseline differences, overall survival, arrhythmia death-free survival, nonarrhythmia death-free survival, and frequency of recurre nt arrhythmias were not found to be gender related. Despite their appa rent ''lower risk'' status on initial presentation, women remained at substantial risk for recurrent arrhythmias. This underscores the need to avoid being unduly biased by the ''appearance'' of health in managi ng women with malignant arrhythmias. That survival and other clinical endpoints were all ultimately independent of gender emphasizes the imp ortance of other clinical variables in assessing risk from ventricular tachyarrhythmias.