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Europace Advance Access published online on October 28, 2009
Europace, doi:10.1093/europace/eup312
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

CLINICAL RESEARCH

Do gender differences exist in pacemaker implantation?—results of an obligatory external quality control program

Bernd Nowak1,*, Björn Misselwitz2 on behalf of the expert committee ‘Pacemaker’, Institute of Quality Assurance Hessen, A. Erdogan3, R. Funck4, W. Irnich5, C.W. Israel6, H.-G. Olbrich7, H. Schmidt8, J. Sperzel9, M. Zegelman10

1 Cardiovascular Centre Bethanien, Im Pruefling 23, D-60389 Frankfurt a.M, Germany; 2 Institute of Quality Assurance Hessen, Eschborn, Germany; 3 Universitätskliniken Marburg and Gießen, Gießen, Germany; 4 Klinikum Bad Hersfeld, Bad Hersfeld, Germany; 5 Wettenberg, Germany; 6 Ev. Krankenhaus Bethel, Bielefeld, Germany; 7 Asklepios Klinik Langen, Langen, Germany; 8 Medizinischer Dienst der Krankenversicherungen in Hessen, Oberursel, Germany; 9 Kerckhoff-Klinik, Bad Nauheim, Germany; 10 Krankenhaus Nordwest, Frankfurt a.M., Germany

Aims: The aim of the study was to evaluate the effects of patient gender onto primary pacemaker implantation, evaluating the database of the Institute of Quality Assurance Hessen in the federal state of Hessen, Germany.

Methods and results: The database of the obligatory external quality control program for the years 2003–2006 was evaluated retrospectively. In 72 centres, 17 826 patients undergoing stationary primary pacemaker implantation have been registered. Male patients had more AV blocks when compared with women and less sick sinus syndrome and atrial fibrillation with bradycardia. In patients being 80 years and older, men received significantly more dual-chamber devices than women for the indications: AV block and sick sinus syndrome. In women, atrial pacing thresholds were significantly higher and P-wave amplitudes were significantly lower. Women had, independent from age or pacing system implanted, significantly more acute complications than men, with significant differences for pneumothorax and pocket haematoma.

Conclusion: This large-scale real-life patient cohort of primary stationary pacemaker implantation showed that gender has an impact onto pacemaker implantation, with less favourable outcomes for women.

Key Words: Pacemaker implantation, Gender, Complications, Quality control

* Corresponding author. Tel: +49 69 945 0280, Fax: +49 69 461 613, Email: b.nowak{at}ccb.de

Manuscript submitted 26 July 2009. Accepted after revision 13 September 2009.


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