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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EA retrospective \u201cbig data\u201d analysis shows that women and men derive a similar survival benefit from both defibrillators and pacemakers. However, women who receive cardiac resynchronization therapy have lower mortality when compared with men. Therefore, strategies must be developed to understand and enhance appropriate utilization of these devices in women.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiac implantable electronic device\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECIED\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epacemakers\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Edefibrillators\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiac resynchronization therapy\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECRT\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiology \u0026amp; cardiovascular medicine clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einterventional techniques \u0026amp; devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EThe influence of sex on the beneficial effect of cardiac implantable electronic devices (CIEDs) has recently been appreciated, but remains poorly characterized. For example, implantable cardiac defibrillators (ICDs) may be less effective in women, whereas cardiac resynchronization therapy (CRT) defibrillators may be more effective. Importantly, women receive fewer implants than men in clinical practice and are underrepresented in clinical trials that evaluate CIEDs, making these questions difficult to answer.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ENiraj Varma, MD, PhD, Cleveland Clinic, Cleveland, Ohio, USA, presented data from a retrospective study of sex-specific survival after a CIED implant. The purpose of the study was to use \u201cbig data\u201d to characterize CIED utilization and postimplant mortality in women compared with men.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn this observational study, data from a cohort of 269\u2005471 patients who received a CIED between 2008 and 2011 were evaluated for the primary outcome of all-cause mortality. CIEDs included pacemakers, ICDs, CRT pacemakers (CRT-P), and CRT defibrillators (CRT-D) from a single manufacturer. All devices were enabled with wireless remote monitoring, and all patients were followed for a minimum of 90 days. Patient demographics were accessed through the St Jude Medical device tracking database, and descriptive statistics were linked by patient ZIP code from the 2012 American Community Survey, which is administered by the US Census Bureau. Date of death was determined by the US Social Security Death Index Master File. The primary end point of all-cause survival was determined for each device type using unadjusted mortality incidence rates and adjusted Cox proportional hazards modeling stratified by age.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe mean age of the cohort was older than 70 years and two-thirds were men. Patients who received ICD implants were on average younger than patients implanted with other CIED devices. Across all device types, follow-up duration and remote monitoring utilization were comparable between sexes. The analysis revealed that a greater proportion of men received CIED implants across all device types. In particular, ICDs and CRT-Ds were implanted significantly less in women than in men. Survival was similar among men and women implanted with a pacemaker or ICD. Importantly, women who received CRT (CRT-D or CRT-P) experienced dramatically improved survival over men in the first 4 to 5 years post-CIED implant.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EDr Varma acknowledged that the limitations of this study included the limited clinical data available for a retrospective, observational analysis and the lack of a nondevice comparison group. However, he also noted that the strengths of the analysis were that it assessed a \u201creal world\u201d cohort of more than 200\u2005000 patients and that it adds a large-scale evaluation of pacemaker and CRT-P patients.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EDr Varma concluded that this analysis suggests that women who receive a CRT-P or CRT-D have enhanced survival rates compared with men. In addition, women implanted with ICDs experienced similar survival rates as men. Therefore, strategies should be developed that ensure appropriate and full utilization of these devices in eligible women.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/22\/7.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl3eq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}