No gender differences in pacemaker selection in patients undergoing their first implantation

Recent studies have indicated that nomen were less likely to receive sophis ticated pacemaker devices than men. These differences could not be fully ex plained by demographic and clinical variables. The purpose of the present s tudy was to assess whether a gender related difference might exist in pacem aker mode selection in patients undergoing their first implantation in The Netherlands. Records of first implants (n = 39,217) collected from 1988 thr ough 1997 covering 93'% of all implantations in The Netherlands. From this population 33,564 (85.6%) patients were included for final analysis. I We o bserved no significant sex differences in pacemaker selection in patients w ith atrioventricular conduction disorders and bundle branch block. In patie nts with sick sinus syndrome, only very old women (greater than or equal to 85 years) had more atrial systems implanted than men of similar age (6.5% vs 3.5%), whereas men received more double chamber pacemakers (12.3% vs 10. 3%) (P = 0.002). However, the relative distribution of physiological versus nonphysiological pacemakers in this subgroup rr as similar for men and wom en. In patients with chronic atrial fibrillation/flutter associated with br adycardia, sex differences were only apparent in the age group of 75-85 yea rs; women received more dual chamber pacemakers (8.8% vs 5.3%) whereas men received more single chamber ventricular pacemakers (94.2% vs 89.8%) (P = 0 .0011). With increasing age, sex differences in pacemaker selection rt ere absent, but there n as a considerable drop in implantation rate of dual cha mber systems. Our study showed no major sex differences in the selection of pacemaker devices. Physicians select pacemaker devices by age rather than gender, which might be a rational choice.