Skip to main content
Journal cover image

Sex Differences in Inappropriate ICD Device Therapies: MADIT-II and MADIT-CRT.

Publication ,  Journal Article
Tompkins, CM; McNitt, S; Polonsky, B; Daubert, JP; Wang, PJ; Moss, AJ; Zareba, W; Kutyifa, V
Published in: J Cardiovasc Electrophysiol
January 2017

INTRODUCTION: Approximately 10-20% of ICD recipients receive inappropriate device therapies. The purpose of this study was to compare the frequency of inappropriate therapies (IT) between men and women enrolled in MADIT II and MADIT-CRT, and assess for potential adverse outcomes. METHODS: The electrograms for each ICD or CRT-D therapy, defined as either ATP or shock, were reviewed by adjudication committees for both studies. ICD therapy was considered inappropriate if it was delivered for reasons other than VT/VF. The rhythm triggering IT was categorized as atrial fibrillation/flutter, SVT, or inappropriate sensing when possible. RESULTS: One thousand nine hundred and fifty-four men and 556 women received ICD or CRT-D devices. The risk of IT was significantly lower in women than men (9.2% vs. 13.5%, P = 0.006). The most common cause of IT in men was atrial fibrillation (38%) and SVT in women (43%). Inappropriate shock was not associated with increased mortality in either women (HR 0.82 [95% CI 0.11-6.08]; P = NS) or men (HR 1.37 [95% CI 0.75-2.48]; P = NS) by multivariate analysis. Conversely, appropriate shock therapy strongly correlated with increased risk of death during subsequent post-shock follow-up in women (HR 5.99 [95% CI 2.75-13.02]; P < 0.0001) and men (HR 2.61 [95% CI 1.82-3.74]; P < 0.0001). CONCLUSIONS: Women experience significantly less IT than men, partially explained by the increased frequency of atrial fibrillation in men. IT was not associated with increased mortality in either sex. Appropriate shock therapy was a strong predictor of death in both, with women showing a 2-fold higher risk than men during post-shock long-term follow-up.

Duke Scholars

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

January 2017

Volume

28

Issue

1

Start / End Page

94 / 102

Location

United States

Related Subject Headings

  • Ventricular Fibrillation
  • Treatment Outcome
  • Tachycardia, Ventricular
  • Tachycardia, Supraventricular
  • Sex Factors
  • Risk Factors
  • Prosthesis Failure
  • Prosthesis Design
  • Prospective Studies
  • Proportional Hazards Models
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tompkins, C. M., McNitt, S., Polonsky, B., Daubert, J. P., Wang, P. J., Moss, A. J., … Kutyifa, V. (2017). Sex Differences in Inappropriate ICD Device Therapies: MADIT-II and MADIT-CRT. J Cardiovasc Electrophysiol, 28(1), 94–102. https://doi.org/10.1111/jce.13102
Tompkins, Christine M., Scott McNitt, Bronislava Polonsky, James P. Daubert, Paul J. Wang, Arthur J. Moss, Wojciech Zareba, and Valentina Kutyifa. “Sex Differences in Inappropriate ICD Device Therapies: MADIT-II and MADIT-CRT.J Cardiovasc Electrophysiol 28, no. 1 (January 2017): 94–102. https://doi.org/10.1111/jce.13102.
Tompkins CM, McNitt S, Polonsky B, Daubert JP, Wang PJ, Moss AJ, et al. Sex Differences in Inappropriate ICD Device Therapies: MADIT-II and MADIT-CRT. J Cardiovasc Electrophysiol. 2017 Jan;28(1):94–102.
Tompkins, Christine M., et al. “Sex Differences in Inappropriate ICD Device Therapies: MADIT-II and MADIT-CRT.J Cardiovasc Electrophysiol, vol. 28, no. 1, Jan. 2017, pp. 94–102. Pubmed, doi:10.1111/jce.13102.
Tompkins CM, McNitt S, Polonsky B, Daubert JP, Wang PJ, Moss AJ, Zareba W, Kutyifa V. Sex Differences in Inappropriate ICD Device Therapies: MADIT-II and MADIT-CRT. J Cardiovasc Electrophysiol. 2017 Jan;28(1):94–102.
Journal cover image

Published In

J Cardiovasc Electrophysiol

DOI

EISSN

1540-8167

Publication Date

January 2017

Volume

28

Issue

1

Start / End Page

94 / 102

Location

United States

Related Subject Headings

  • Ventricular Fibrillation
  • Treatment Outcome
  • Tachycardia, Ventricular
  • Tachycardia, Supraventricular
  • Sex Factors
  • Risk Factors
  • Prosthesis Failure
  • Prosthesis Design
  • Prospective Studies
  • Proportional Hazards Models