Elango Kalaimani, Curtis Anne B
Department of Medicine, University at Buffalo, New York.
Clin Cardiol. 2018 Feb;41(2):232-238. doi: 10.1002/clc.22903. Epub 2018 Feb 26.
Clinical trials have demonstrated the benefits of cardiac implantable electrical devices, which include pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT), with respect to key clinical outcomes and survival. Women more often require permanent pacing for sick sinus syndrome, whereas atrioventricular block is more common in men. Women appear to have a higher incidence of complications with pacemaker implantation, as well as with ICD and CRT implantation. The indications for ICDs and CRT do not have any distinctions based on sex, and outcomes are comparable in men and women. In fact, women often seem to have better outcomes with CRT compared with men. Despite the demonstrated benefits of these devices, ICDs and CRT are underutilized in women. In this review, we explore sex differences in utilization, outcomes, and complications with pacemakers, ICDs, and CRT.
临床试验已证明植入式心脏电子设备（包括起搏器、植入式心脏复律除颤器（ICD）和心脏再同步治疗（CRT））在关键临床结局和生存率方面的益处。女性因病态窦房结综合征更常需要永久性起搏，而房室传导阻滞在男性中更为常见。女性起搏器植入以及ICD和CRT植入的并发症发生率似乎更高。ICD和CRT的适应证不存在基于性别的差异，男性和女性的治疗效果相当。事实上，与男性相比，女性接受CRT治疗似乎往往有更好的效果。尽管这些设备已证明有益，但ICD和CRT在女性中的使用不足。在本综述中，我们探讨起搏器、ICD和CRT在使用、治疗效果及并发症方面的性别差异。
