Women overlooked for pacemakers despite advances in technology

Despite major advances in technology men are twice as likely as women to receive a pacemaker, even after adjusting for confounders, a large Australian registry study reports. 

The retrospective population study of over 7 million people from the NSW Admitted Patient-Data-Collection registry identified a nearly two-fold difference in the rate of permanent pacemaker implants (PPI) between men and women, a trend which persisted over a 10-year period. 

The cardiologists from Concord Hospital in Sydney noted that while it was often reported that women typically present with atypical symptoms, there was nothing in the literature to back this up and was therefore unlikely to explain their findings. 

“Other possibilities include physician avoidance of PPI in women because of systematic bias, or concern regarding a perceived increased risk of complications in women, multiple co-morbidities and smaller body size presenting a more challenging implantation,” they wrote in PLOS ONE. [link here].

While in-hospital mortality was low, with no difference seen between sexes, non-fatal in-hospital complications were higher in women compared to men (8.2% vs 6.6%, P<0.01), and this persisted throughout the study period after adjustment for multiple factors. 

“The surprising finding [in the present study] was despite advances in technology, and greater utilisation, there was consistently higher rates of PPI in men than in women in the Australian population and the gap appears widening,” the researchers concluded. 

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