Intermountain Press Release

Salt Lake City—Research from LDS Hospital and the Cleveland Clinic contradicts previous studies and may change how doctors treat women heart patients

Though heart disease is equally common in men and women, women are less likely to have life-saving cardiac procedures performed, such as implantation of heart failure pacemaker defibrillators. One reason: the concern that women may experience more complications during some procedures.

However, a new international study led by cardiac researchers at LDS Hospital and the Cleveland Clinic suggests that isn't the case at all. The study, which looked at outcome differences between 1,268 men and women, found that women fared just as well as men with the implantation of heart failure pacemaker defibrillators.

This is the first study of its kind to compare outcomes between genders for this procedure. Study findings were presented at the annual scientific sessions of the National Heart Rhythm Society in Denver.

"The study provides positive new hope for women," says John Day, M.D., an interventional cardiologist at LDS Hospital and one of the study's lead authors. "These results are likely to reassure physicians about this lifesaving technology for their female patients with heart disease."

The pacemaker defibrillator is a two-in-one device implanted just beneath the skin near the shoulder. Three leads are inserted in the vein and attach to the heart. The pacemaker strengthens the heart and allows the person to feel better, and in the event of cardiac arrest, the defibrillator automatically shocks the heart back into action.

Like many other kinds of cardiac procedures, this life-saving device has been far underutilized for female patients, says Dr. Day.

The multi-center international cardiac study was directed by LDS Hospital and the Cleveland Clinic and involved 1,268 patients from 129 medical centers from around the world. Thirty-four percent of the patients were women (426) and 66 percent were men (842).

Led by investigators Dr. Day of LDS Hospital and David Martin, M.D., of the Cleveland Clinic, researchers compared the results for men and women for such things as complications, infection, repeat correctional procedures, length of time for procedure, and hospital stay. They found little to no difference between men and women in these outcomes.

Dr. Day says these findings counter "perceived" notions that have led to the perception that women don't do as well as men with these cardiac procedures.

There are a number of potential explanations why this bias exists among physicians, he says. Some have suggested that women have smaller vessels that make it more difficult to perform these surgeries or procedures. Others have suggested that cardiac disease is recognized later in women so that by the time they need a procedure or surgery there are more problems.

"We expect studies like this will let physicians know that women fare just as well as men with the implantation of a heart failure pacemaker defibrillator. Not only can these devices improve the quality of life for patients, but they save lives. With this type of information we hope the gender bias in the utilization of this life-saving technology will narrow," Dr. Day says.