Influence of gender on ICD implantation for primary and secondary prevention of sudden cardiac death

Aims This study sought to investigate the influence of gender on access to ICD therapy and examine the influence of gender on subsequent ICD shock experience. Methods and results The records of 353 consecutive patients (140 and 213 secondary prevention, respectively) who received their first ICD between January 2000 and March 2004 were reviewed. All patients fulfilled criteria for primary or secondary prevention ICD implantation. Baseline characteristics and ICD shock experiences were compared. Female patients were younger and less likely to have a history of ischaemic heart disease or atrial. arrhythmias (P < 0.01). In contrast, female patients were more likely to have heart failure and diabetes (P < 0.01). Markedly fewer females received an ICD for either primary (M:F ratio 8.5: 1, P < 0.01) or secondary (M:F ratio 4.51, P < 0.01) prevention. Further, significantly fewer female patients received an ICD for MADIT 11 indications (M:F 11.2:1, P < 0.01). Over the mean follow-up of 1.8 +/- 1.1 years, gender had no influence upon the likelihood of receiving either an appropriate or an inappropriate shock (P = ns). Conclusion Although mate patients accounted for the great majority (85%) of all ICD recipients, there was no evidence of influence of gender on the likelihood of receiving an appropriate or inappropriate shock.