{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:00:50Z","timestamp":1773298850984,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,24]],"date-time":"2013-04-24T00:00:00Z","timestamp":1366761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Several meta\u2010analyses of the implantable cardioverter\u2010defibrillator (ICD) clinical trials have demonstrated that while men derived a mortality reduction with prophylactic ICD implantation, women did not. These trials also observed that women receive less appropriate ICD shock therapy compared to men. We aimed to investigate this \u201cgender\u2010paradox\u201d among a heterogeneous community cohort of patients receiving ICDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 1,445 consecutive patients undergoing ICD implantation from 1997 to 2007. The study population consisted of 582 patients, of whom 291 were women who could be propensity matched to 291 men, based on age, ejection fraction, implantation indication (primary or secondary), etiology of cardiomyopathy (ischemic or nonischemic), and the presence of a cardiac resynchronization therapy\u2010defibrillator (CRT\u2010D) device. The impact of gender difference on the probability of death and appropriate ICD shocks for ventricular arrhythmias was calculated using multivariable Cox proportional hazards analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a mean follow\u2010up of 909 \u00b1 901 days, compared to men, women demonstrated a similar risk of death (25% vs 25%, adjusted hazard ratio [AHR] 1.05 [95% confidence interval (CI) 0.81\u20131.35], P = 0.74). In contrast, women demonstrated a decreased probability of appropriate ICD\u2010shock therapy (14% vs 19%, AHR 0.80 [95% CI 0.59\u20130.88], P = 0.03) compared to men, and among cohorts with a nonischemic cardiomyopathy (10% vs 20%, P &lt; 0.001) and CRT\u2010D devices (7% vs 19%, P = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among a community cohort with ICDs, women have a similar mortality compared to men while experiencing less appropriate ICD therapy. These results support the findings of a lower arrhythmic mortality among women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12141","type":"journal-article","created":{"date-parts":[[2013,4,24]],"date-time":"2013-04-24T17:25:52Z","timestamp":1366824352000},"page":"878-884","source":"Crossref","is-referenced-by-count":22,"title":["The Gender\u2010Paradox among Patients with Implantable Cardioverter\u2010Defibrillators: A Propensity\u2010Matched Study"],"prefix":"10.1111","volume":"36","author":[{"given":"SANJEEV P.","family":"BHAVNANI","sequence":"first","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"VAMSIMOHAN","family":"PAVULURI","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CRAIG I.","family":"COLEMAN","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DANETTE","family":"GUERTIN","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RAVI K.","family":"YARLAGADDA","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CHRISTOPHER A.","family":"CLYNE","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JEFFERY","family":"KLUGER","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Section of Heart Rhythm Management, and the Evidence Based Practice Center Hartford Hospital  Hartford Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1056\/NEJMoa043399","article-title":"Amiodarone or an implantable cardioverter\u2010defibrillator for congestive heart failure","volume":"3","author":"Bardy GH","year":"2005","journal-title":"N Engl J Med"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1056\/NEJM199711273372202","article-title":"Investigators. A comparison of antiarrhythmic\u2010drug therapy with implantable cardioverter defibrillators in patients resuscitated from near\u2010fatal ventricular arrhythmias","volume":"337","author":"The Antiarrhythmic Versus Implantable Cardioverter Defibrillators (AVID).","year":"1997","journal-title":"N Engl J Med"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1056\/NEJMoa033088","article-title":"Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy","volume":"350","author":"Kadish A","year":"2004","journal-title":"N Engl J Med"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.13.1517"},{"key":"e_1_2_8_9_1","first-page":"467","article-title":"The impact of gender on survival amongst patients with implantable cardioverter defibrillators for primary prevention against sudden cardiac death","volume":"260","author":"Henyan NN","year":"2006","journal-title":"J"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.255"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.03.042"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2005.00224.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2004.04050.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.03.031"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.014324"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.055"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.12.013"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.111.962902"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.955039"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00184-3"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.111.971549"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.06.062"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.03.018"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.01.007"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.11.041"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.02.039"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa071098"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000150390.04704.B7"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.02.026"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpace.12141","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.12141","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T10:44:11Z","timestamp":1696243451000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.12141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,24]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1111\/pace.12141"],"URL":"https:\/\/doi.org\/10.1111\/pace.12141","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,24]]}}}