Arrhythmias & electrophysiologyCohort study
Subcutaneous Implantable Cardioverter-Defibrillator Therapy in Women
- nationwide cohort
- centrally adjudicated clinical endpoints
- propensity score-based inverse probability weighting
Authors' conclusion
Women receiving an S-ICD experienced fewer appropriate shocks, with similar overall complication and reintervention rates, but a distinct complication profile. These findings support sex-informed S-ICD selection and follow-up. (S-ICD French Cohort Study [HONEST]; NCT05302115).
Study context
- Population
- All patients who received an subcutaneous implantable cardioverter-defibrillator (S-ICD) in France between 2012 and 2019S-ICD recipients, 1,148 were women (23.3%)
- Participants
- 4,924 patients
- Exposure
- Women vs men among S-ICD recipients
- womenn = 1,148
Main finding
Appropriate shocks · 5-year
Hazard ratio
0.85
95% CI 0.74–0.98
P = 0.023
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Inappropriate shocks · lower risk in women | 0.64 (0.50–0.82) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Age
Implant for primary prevention
Coronary artery disease
Electrical heart disease
- Age: P < 0.001
- Implant for primary prevention: P < 0.001
- Coronary artery disease: P < 0.001
- Electrical heart disease: P < 0.001
Overall complication and reintervention rates
- similar overall complication and reintervention rates
All-cause mortality
- All-cause mortality was lower in women
S-ICD-unresponsive sudden death and device-related mortality
- similar
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Chronic pain · higher risk in women | 2.63 (1.61–4.29) | P < 0.001 | |
| Lead dislodgment · higher risk in women | 1.79 (1.09–2.95) | P = 0.022 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Summarised from the published abstract; every number is checked against it