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Heart disease doesn’t discriminate based on gender. But treatment sometimes does. Men are more likely to receive life-saving cardiac procedures, such as use of combination pacemaker-defibrillators.
Research released Monday by LDS Hospital and Cleveland Clinic, the two lead institutions on a 130-facility international study of how women fare with the device compared to men, says there’s no reason for the bias. Women do just as well.
“Hopefully, studies like this will show that if women qualify for these life-saving therapies, they do just as well,” said Dr. John Day, an interventional cardiologist at LDS Hospital and one of the lead investigators, with Dr. David Martin of Cleveland Clinic. “It’s hard to know why they’re underutilized in women versus men.”
The study looked at special combination pacemaker defibrillators designed for use by heart failure patients. The three-lead devices (most combo units have two leads) are connected to the heart and have been shown to improve heart function, increase exercise tolerance, decrease need for doctor visits and more, Day said.
In trying to resolve the gender-bias question, they looked at everything they could think of, he said. “Is there a difference in outcomes? Do women have more complications or are the surgeries more complex? Are they stuck in the hospital longer or is the device harder to install? We tried to look at all of the questions.”
Between December 2004 and November 2006, they looked at differences in outcome for 1,268 men and women who had the heart- failure pacemaker defibrillators implanted. One-third of the patients with the implanted devices were women.
They found no difference at all.
“Women did just as well, with no increased complications,” said Day.
The device is implanted just under the skin near the shoulder, then the leads are inserted into the vein and attached to the heart muscle. The pacemaker helps the heart keep pace and strengthens it. Should the heart stop beating, the defibrillator automatically shocks the heart to restore rhythm. It can also be triggered deliberately if needed.
That happened to Salt Lake City resident Marion Payne, who has had one of the devices since August. She’d suffered long bouts of atrial fibrillation. She underwent an ablation to “short circuit” the section of the heart’s wiring that was going awry. But after she had pneumonia last May, she again had atrial fibrillation and was implanted with the pacemaker-defibrillator a few weeks later. It’s never shocked her on its own, but her doctor activated the defibrillator function once to restore her heart rhythm.
She’s had no problems or complications with the device, she said.
E-mail: lois@desnews.com
Copyright C 2007 Deseret News Publishing Co.
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